I just got access to the benefit info for my new jobert and want to start figuring it out even if I won’t be eligible for a couple more months.
There’s a Gold PPO and a Platinum HMO, and the company takes care of the premium for both. The HMO is cheaper in pretty much every way (4x cheaper therapy for instance) but I know you’re a lot more restricted in terms of staying in network and needing referrals.
If I go for an HMO will I have a harder time getting HRT? I’m not really looking at any surgeries in the next year, so I could switch to a PPO later if there were any network issues with that.
Honestly, the actual thing you need to check is the benefit structure of the insurance plans. You need to see which medications are on the formulary, covered conditions, procedures, etc. See if your doctors or hospital system are in the network, or if it will be incredibly difficult to stay in-network in your area. Nobody wants to be in the situation where they have to travel to another city in order to go to the ER or even a regular check-up.
HMO stands for Hand the Money Over
My wife’s BCBS PPO has been ungodly great for my trans care. My bottom surgery didn’t cost a dime and my meds are well covered.
If you live in a US blue state I think the HMO will be fine. Otherwise you should probably figure out which local hrt provider you will want to use and see if they will work with your insurance.
Ya I’m bloo. I could also go through Cost Plus Drugs to get it for pretty cheap sans insurance I guess
In my experience, PPOs are nearly as restrictive as HMOs, but far more arcane.
I have had many experiences where in attempting to see a doctor, I find one that seems to accept my insurance, only to later discover that they only accept the platinum plan, and I’m on the Platinum PLUS plan, so actually none of my visits were covered.
With an HMO (I had kaiser, which was by far the best healthcare I’ve ever had) shit was obvious. You got treatment from the HMOs offices, and you were covered.
