Best Gold PPO for 2016

Dec 2, 2015

  1. topher
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    topher New Member

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    Hello,

    I currently have the BCBS Gold PPO and received the dreaded letter stating the switch over to the Blue Choice Network. I do not want this network as alot of hospital systems I visit will not be included (Northwestern, Rush, U of C, etc...) What is my best option for the highest level Gold PPO for 2016? I am a 28yr old male, physically fit, former athlete. I do not have any health conditions, but I do need a couple surgeries to repair various body parts from all the wear and tear of playing sports at such a high level. My biggest fear is picking a PPO plan that will cut me off or simply deny my coverage because of the surgeries. I also want to visit ortho surgeons at a couple of the above mentioned hospitals.

    Could someone please recommend the best Gold level PPO I can purchase for next year? I would ultimately prefer a platinum level, but I don't think this is offered anymore?

    Thank You!
     
    topher, Dec 2, 2015
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  2. SamIam
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    SamIam Guru

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    The metallic level doesn't matter it's the network. If you want Rush your probably going to have to use United Healthcare because they are not working with Blue Cross or Land of Lincoln on the individual plans.
     
    SamIam, Dec 2, 2015
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  3. topher
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    topher New Member

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    Yea, I called them and they said they are only taking Harken next year. I'm a little hesitant since it's a startup. From what I've gathered, it seems to be either Harken or Coventry, however, the Harken is like $380ish/month vs $510/month for the Coventry. Why the big discrepancy?
     
    topher, Dec 2, 2015
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  4. Rick441
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    Rick441 New Member

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    If you're in Cook County look at Harken Health. They are a (supposedly independently-operated) new division of UnitedHealthcare that uses the broad UHC network. Includes Rush and all the other area hospitals, plus most doctors. They prefer you make one of their four new Harken Health centers your first stop, but it's not required. It's a PPO, not an HMO, EPO or POS. No referrals are required.

    Of course there's always the option to choose new QHP Ambetter Illinicare and go to one of their four hospitals, if assigned PCP Dr. Granny Clampett will write you a referral.
     
    Last edited: Dec 3, 2015
    Rick441, Dec 3, 2015
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  5. topher
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    topher New Member

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    Yea i was looking at harken and thats the only one Rush will take. It seems to be between Harken and Coventry. Why is harken 380ish vs 510 for coventry? Im in the SW burbs cook county
     
    topher, Dec 3, 2015
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  6. AllenChicago
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    AllenChicago Guru

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    I have two clients placed with Harken for the very reasons you've stated, Topher Their doctors are Rush affiliated and they don't want to change.

    I'll send you a Private forum message, explaining why Coventry cost so much. If you want guidance, I'll give you a hand.

    -Allen
     
  7. topher
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    topher New Member

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    Sounds good.

    I am trying to get something setup for next year and the broker I called bailed on me. From my own research, it seemed like between Harken and Conventry. I'm not necessarily married to Rush, but if I ever wanted to go to them for care I would need Harken to be covered. It gets confusing because I visit Midwest Ortho for ortho care which is at Rush, however they are covered either way since they are "independent" but operate at Rush locations. If I had surgery, it seems likes insurance would cover the procedure, but I would end up paying the hospital bills since they utilize Rush hospitals which wouldn't be covered?
     
    topher, Dec 3, 2015
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  8. cris2016
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    cris2016 New Member

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    I'm going to send you a msg also with some questions, if you don't mind.
     
    cris2016, Mar 31, 2016
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