Lets talk about health insurance..

[Mikey P]

Im getting kicked off the SCruz company plan so Im shopping...


Anyone familiar with this?

ALTRUA HEALTHSHARE ENHANCED MEMBERSHIP MRA = MEMBER RESPONSIBILITY AMOUNT
1st MRA*	$1,500 per member per calendar year
2nd MRA* 70/30 CO-INSURANCE, MAX OOP IS $4,000	25% of next $10,000 per member ($2,500 max) with an affiliated provider/facility or Maximum of $5,000 if Medicare Plus 25% isn’t accepted and/or the licensed medical professional/ facility is non-affiliated. The membership shares in eligible needs at 100% after the 1st, then 2nd MRAs are met, and simultaneously, as the 2nd MRA is being met.1
Annual Maximum Limit	$250,000 per member
Lifetime Maximum Limit	$1,000,000 per member
Office, Urgent Care & Specialist Visits (30-day waiting period)	Primary Care Physician MRA: $35 per member, per visit (not applied to the 1st or 2nd MRAs) Specialist MRA: $50 per member, per visit (not applied to the 1st or 2nd MRAs) Maximum Visits: Member Only - 3 visits per member, per calendar year Member + 1 - 6 visits per family, per calendar year Households of 3-5 members - 9 visits per family, per calendar year (3 office visits are added to the family maximum for each dependent after number 5) After the maximum visits has been reached, the member is responsible for 100% of charges. Sharing amount: Up to $300 per visit ² For female members age 40 and over, for a mammogram visit, the membership will share up to $500 with the $35 office visit MRA
Wellness/Preventative Visit	Female members age 40 and over Male members age 50 and over Eligible for sharing of one additional office visit during the calendar year
Flu Shot	Reimbursement only. Max of $25 per member, per calendar year
Laboratory Services	90 day waiting period (unless part of wellness or preventative care visit) Sharing amount: $4,000 maximum per member, per calendar year; applied toward the 1st, then 2nd MRA.3
Emergency Room	Sharing amount: Eligible ER visits are shared at the allowed amount - based on the facility repricing amount of Medicare +50%; MRA applies.
Cancer Treatment	12 month waiting period for cancer treatment 1st, then 2nd MRAs apply Biennial screening requirements for females 40 and over and males If a required biennial screening is missed, with clean results on file, the member is responsible for 50% of the allowed amount after meeting cancer treatment MRA.
WAITING PERIODS
Eligible 30 days from the membership effective date	Office, Urgent Care & Specialist Visits
Eligible 90 days from the membership effective date	Lab Sharing Advanced imaging (for example, MRI, MRA, CT, or PET scans. Advanced imaging does not apply to routine mammogram screening) Bone density scans Cardiac testing, procedures and treatments EGD (upper endoscopy) procedures EMG/EEG tests Infusion therapy In-office procedures (e.g., joint injection, skin biopsy) Inpatient hospital admission (unless admitted through the ER or a direct admission from a Physician) Long term care—any and all treatments involved Nuclide studies Ophthalmic surgical procedures Outpatient surgery, testing, and procedures (including pre-admission testing) Sleep studies Ultrasound scans (does not apply to maternity or routine mammograms)
Eligible 12 months from the membership effective date	Cancer Treatment

IMPORTANT INFORMATION

*Applies to practitioners and facilities. ¹ Limitations apply. See Membership Guidelines for more information. (5.5 Medical Needs that are Not Eligible for Sharing) ² Not applied to the 1st or 2nd MRA ³ Laboratory services must be obtained through an in-network facility to be eligible for sharing. Dependent children are accepted up to age 22. Children 23 years old and older must apply for their own membership.

PHCS PROVIDER NETWORK

Altrua HealthShare includes the PHCS Network through MultiPlan, Inc. Members have access to a premier national network that includes access to 223,113 Primary Care Providers, 89,444 Ancillary providers and 660,047 Specialists. MultiPlan negotiates discounts that result in significant cost savings when members visit in-network providers, helping to maximize their health services. A PHCS logo on the ID card tells both the Member and the Provider that a PHCS discount applies. Members can find participating doctors or facilities near them by going to www.multiplan.com and following the instructions below or by calling (888) 244-3839. Home page 1 - Click on "Find a Provider" Find a doctor or facility page 2 - Click on the "Select Network" button and choose "PHCS" 3 - Click on "Extended PPO" 4 - Type in the search criteria and location It is the Members’ responsibility to confirm the provider or facility’s continued participation in the PHCS Network and accessibility under the shared services program. When scheduling an appointment, Members need to specify that they have access to the PHCS Extended PPO Network, confirm the provider’s current participation in the PHCS Network, their address and that they are accepting new patients. In addition, to ensure proper handling of their bills, Members should always present their Altrua HealthShare ID card upon arrival at your appointment. Please note: MultiPlan, Inc. and its subsidiaries are not insurance companies, do not pay claims and do not guarantee health benefit coverage. Click Here to Search for Providers

 

[The Great Oz]

First question: What's that plan cost you per month - and compared to what?

Second question: Does the local JC have a janitorial opening?

 

[Mikey P]

450 for the two of us through this deal, $1800 through more traditional insurers ..

 

[The Great Oz]

Not bad for catastrophe insurance, which seems like all we can get anymore.

 

[Desk Jockey]

We do have a good deal on insurance, its Blue Cross same as what we had at the shop but $600.00 for family with vision and dental and it was over $1200.00 there.

Its totally free if you're a single plan but..then the wife would get 1/2 of everything else.

 

[hogjowl]

That took me a minute
I suppose I should laugh to make you feel better

 

[Cleanworks]

Im getting kicked off the SCruz company plan so Im shopping...


Anyone familiar with this?

ALTRUA HEALTHSHARE ENHANCED MEMBERSHIP MRA = MEMBER RESPONSIBILITY AMOUNT
1st MRA*	$1,500 per member per calendar year
2nd MRA* 70/30 CO-INSURANCE, MAX OOP IS $4,000	25% of next $10,000 per member ($2,500 max) with an affiliated provider/facility or Maximum of $5,000 if Medicare Plus 25% isn’t accepted and/or the licensed medical professional/ facility is non-affiliated. The membership shares in eligible needs at 100% after the 1st, then 2nd MRAs are met, and simultaneously, as the 2nd MRA is being met.1
Annual Maximum Limit	$250,000 per member
Lifetime Maximum Limit	$1,000,000 per member
Office, Urgent Care & Specialist Visits (30-day waiting period)	Primary Care Physician MRA: $35 per member, per visit (not applied to the 1st or 2nd MRAs) Specialist MRA: $50 per member, per visit (not applied to the 1st or 2nd MRAs) Maximum Visits: Member Only - 3 visits per member, per calendar year Member + 1 - 6 visits per family, per calendar year Households of 3-5 members - 9 visits per family, per calendar year (3 office visits are added to the family maximum for each dependent after number 5) After the maximum visits has been reached, the member is responsible for 100% of charges. Sharing amount: Up to $300 per visit ² For female members age 40 and over, for a mammogram visit, the membership will share up to $500 with the $35 office visit MRA
Wellness/Preventative Visit	Female members age 40 and over Male members age 50 and over Eligible for sharing of one additional office visit during the calendar year
Flu Shot	Reimbursement only. Max of $25 per member, per calendar year
Laboratory Services	90 day waiting period (unless part of wellness or preventative care visit) Sharing amount: $4,000 maximum per member, per calendar year; applied toward the 1st, then 2nd MRA.3
Emergency Room	Sharing amount: Eligible ER visits are shared at the allowed amount - based on the facility repricing amount of Medicare +50%; MRA applies.
Cancer Treatment	12 month waiting period for cancer treatment 1st, then 2nd MRAs apply Biennial screening requirements for females 40 and over and males If a required biennial screening is missed, with clean results on file, the member is responsible for 50% of the allowed amount after meeting cancer treatment MRA.
WAITING PERIODS
Eligible 30 days from the membership effective date	Office, Urgent Care & Specialist Visits
Eligible 90 days from the membership effective date	Lab Sharing Advanced imaging (for example, MRI, MRA, CT, or PET scans. Advanced imaging does not apply to routine mammogram screening) Bone density scans Cardiac testing, procedures and treatments EGD (upper endoscopy) procedures EMG/EEG tests Infusion therapy In-office procedures (e.g., joint injection, skin biopsy) Inpatient hospital admission (unless admitted through the ER or a direct admission from a Physician) Long term care—any and all treatments involved Nuclide studies Ophthalmic surgical procedures Outpatient surgery, testing, and procedures (including pre-admission testing) Sleep studies Ultrasound scans (does not apply to maternity or routine mammograms)
Eligible 12 months from the membership effective date	Cancer Treatment

IMPORTANT INFORMATION

*Applies to practitioners and facilities. ¹ Limitations apply. See Membership Guidelines for more information. (5.5 Medical Needs that are Not Eligible for Sharing) ² Not applied to the 1st or 2nd MRA ³ Laboratory services must be obtained through an in-network facility to be eligible for sharing. Dependent children are accepted up to age 22. Children 23 years old and older must apply for their own membership.

PHCS PROVIDER NETWORK

Altrua HealthShare includes the PHCS Network through MultiPlan, Inc. Members have access to a premier national network that includes access to 223,113 Primary Care Providers, 89,444 Ancillary providers and 660,047 Specialists. MultiPlan negotiates discounts that result in significant cost savings when members visit in-network providers, helping to maximize their health services. A PHCS logo on the ID card tells both the Member and the Provider that a PHCS discount applies. Members can find participating doctors or facilities near them by going to www.multiplan.com and following the instructions below or by calling (888) 244-3839. Home page 1 - Click on "Find a Provider" Find a doctor or facility page 2 - Click on the "Select Network" button and choose "PHCS" 3 - Click on "Extended PPO" 4 - Type in the search criteria and location It is the Members’ responsibility to confirm the provider or facility’s continued participation in the PHCS Network and accessibility under the shared services program. When scheduling an appointment, Members need to specify that they have access to the PHCS Extended PPO Network, confirm the provider’s current participation in the PHCS Network, their address and that they are accepting new patients. In addition, to ensure proper handling of their bills, Members should always present their Altrua HealthShare ID card upon arrival at your appointment. Please note: MultiPlan, Inc. and its subsidiaries are not insurance companies, do not pay claims and do not guarantee health benefit coverage. Click Here to Search for Providers

Cheaper to move to Canada.

 

[Brian H]

Cheaper to move to Canada.

And have to wait 2 years for a knee replacement like my Aunt did.

 

[Nomad74]

Marry a teacher.

 

[hogjowl]

I did
She immediately quit

 

[Pioneer Floorcare]

I did
She immediately quit

She quit you or the job?!

 

[hogjowl]

Hilarious

 

[Nomad74]

$701 is whats taken out of my wife’s check each month for our insurance. $2000 deductible and 80/20 coverage with 100% dental if you get 2 yearly checkups. If you don’t get the yearly check ups then the dental only covers 80%.

 

[Mikey P]

$701 is whats taken out of my wife’s check each month for our insurance. $2000 deductible and 80/20 coverage with 100% dental if you get 2 yearly checkups.

kids too?


wow

 

[Nomad74]

kids too?


wow

Yes. Kids also. Is that a good deal? I honestly don’t know.

 

[hogjowl]

My sons BCBS went from $125 a month to $565 in 2021. $4000 deductible. No dental. Just him on the plan.

 

[Desk Jockey]

My sons BCBS went from $125 a month to $565 in 2021. $4000 deductible. No dental. Just him on the plan.

Was there a lot of usage in the group? If the group isn't big enough and lots of usage it could make it jump. Also age of the group, too many oldies with not enough young guys would affect our rate at the shop.

 

[hogjowl]

No group. Just him through the exchange. He went to the doctor for the first time while on the plan. Previous three years he never used it. Just a checkup.

 

[Desk Jockey]

I have no experience with the exchange.

 

[Ron K]

I did
She immediately quit

Being Married?

 

[hogjowl]

You’re hilarious too

 

[Chris A]

Wifey drives bus for the schools, $600/mo for the whole famdamily, $500 deductible

 

[Fat Mike]

Wifey drives bus for the schools, $600/mo for the whole famdamily, $500 deductible

I heard bus driving for kids is brutal. I’ve known several drivers.

 

[Mikey P]

I heard bus driving for kids is brutal. I’ve known several drivers.

I tormented a few.

 

[Chris A]

She likes it, but some days are rougher than others lol. She definitely likes her elementary kids more than her middle school pukes

 

[Joseph225]

What I saw, looks like a good policy. Wish that sort of thing was available in VA. When Trump first came in, the market was already shaky. After all his shenanigans, we wound up with just one provider in the whole state. Our policies are shit...but they'd been much better prior to that.

 

[Mikey P]

What I saw, looks like a good policy. Wish that sort of thing was available in VA. When Trump first came in, the market was already shaky. After all his shenanigans, we wound up with just one provider in the whole state. Our policies are shit...but they'd been much better prior to that.

Ill ask if it available in Virginia

 

[Mikey P]

What I saw, looks like a good policy. Wish that sort of thing was available in VA. When Trump first came in, the market was already shaky. After all his shenanigans, we wound up with just one provider in the whole state. Our policies are shit...but they'd been much better prior to that.

She has great options for Virginia


assuming to can abide by these life standards...


This household lives according to each item in the Statement of Standards
I/we agree to live a clean and healthy lifestyle and share the following ethical and religious beliefs:

• I believe in caring for one another.
• I believe in keeping my body clean and healthy with proper nutrition.
• I believe the use of tobacco, illicit drugs and excessive alcohol consumption is harmful to the body and soul.
• I believe sexual relations outside the bond of marriage is contrary to the teachings of the Bible and that marriage should be held in honor.
• I believe abortion is wrong, except in a life-threatening situation to the mother.
• I believe I am obligated to care for my family and physical, mental or emotional abuse of any kind to a family member or anyone else is morally wrong.

I/we abide by the Commitments.

 

[Mikey P]

lol...you lied on several of these just to get cheap health insurance

I lied about my weight too


Saved me $40 a month

 

[Nomad74]

She has great options for Virginia

I read this totally wrong at first.