Blue Cross / Blue Shield Review

We currently use Blue Cross Blue Shield of North Carolina (BCBS of NC) because this is the program offered through my husband's work. I am grateful to have health insurance through his work because I have seen premiums for health insurance not associated with an employer, and the numbers are not pretty for any health insurance.

Costs:

Most health insurance is expensive these days. If you are fortunate to have insurance through an employer, you may have less expensive premiums, but they still are not cheap. It seems that less and less is covered these days. I used to have 100% coverage on allergy shots and now must pay a percentage. A lot of preventive care that used to be covered now requires a co-pay.

However, after reading what BCBS of NC does and does not pay for, it seems like they have covered what they are supposed to cover, at least in our case. We've had more problems with various specialists and general practitioners trying to charge us incorrectly than with the insurance covering costs incorrectly. We do receive a statement from the insurance company stating what we owe, and I tend to wait to pay bills until I have received the insurance statement unless it is a co-pay that has a flat amount.

I had my last baby with BCBS health insurance and ended up having an emergency C-section. Our insurance did cover what they said they would cover. We have a family of five, and four of us see at least one specialist, and we've had several tests done, and BCBS has covered the stated percentages listed.

Most insurance companies are in the business to make money, so they tend to charge for things like pre-existing conditions unless your place of business is transferring from one carrier to another. People who need insurance the most are typically charged the most unless it's a flat rate through an employer. As more and more people seem to be losing their jobs with the tough economy, I look for things to get much worse with the cost of healthcare and insurance. I hope that will not be the case, but I have heard that most people in the United States who file bankruptcy get into financial difficulties due to medical bills.

Ease of Use:

I have found Blue Cross Blue Shield of NC to be easier to use than some insurance companies. Most hospitals and clinics accept BCBS. I remember when a large hospital in our area decided to stop accepting BCBS--it was a disaster for the hospital and now that hospital not only accepts BCBS, but they also offer it to the employees of the hospital and to their Medical School employees.

They do have an informative and easy-to-navigate website. I've looked up numerous physicians on their website to see if they accept BCBS, and the website gives lots of helpful information related to those physicians, such as contact information, address, and even if the physician is male/female or speaks other languages. They also provide information about drugs and health problems on the website as well.

I like the fact that BCBS does not require a referral in order to see a specialist. I've had another health insurance that required a referral every year. It did not matter if you had seen that specialist for eight years. You had to get a referral each year in order to have any visits to that doctor covered. That was a pain, and I'm glad that BCBS does not require referrals. However, some specialists require a referral from the primary doctor before they will make an appointment.

Preventive Care and Incentives:

I would like to see BCBS cover more preventive measures. I think it would be awesome if a health insurance company would cover things such as a yearly physical for adults and children and whatever screening tests were deemed appropriate by the primary physician. I also think it would be to a health insurance's benefit to cover the cost of a health club membership if the person could prove that they are actually using it. Of course, I don't think that any health insurance is actually that progressive. Most health insurance companies will much more readily pay towards having a leg amputated than they will for preventive programs for diabetes, for example.

BCBS does cover some well child visits and scheduled immunizations on our plan.

BCBS of NC does have a very nice incentive program called Blue Points. BCBS does not offer Blue Points in every state or with every option, but I have benefited from the program since I discovered how easy it is to use. They have just updated the program in January 2009. After joining the Blue Points program, you may go online and enter several different healthy things that you might do, such as exercising or eating fruits/vegetables or you may take surveys or sign up to receive information on different health-related programs. You receive points for each item entered. These points may now be redeemed for better prizes than before, including gift cards, merchandise, and donations to charity. The merchandise ranges from a digital thermometer to a plasma TV or treadmill. The gift cards include places like Amazon, Macy's, KMart, Disney, Bass Pro Shop, and much more and typically run $25, $50, or $100. Of course, it would take about five years to add up enough points to get those top merchandise awards, but if you exercise regularly, eat a consistent healthy diet, take a few surveys, and are diligent in recording the information, you can collect enough points in less than two months to qualify for a $25 gift card or a little over half a year to earn a $100 gift card. Now we're talkin'!

BCBS also offers discounts on some alternative therapies and vitamins, but I have not taken advantage of those programs.

Customer Service:

I have called BCBS of NC several times to check on a bill from various providers, and at times I've had to wait for a while to speak to someone. I've learned to use a cordless phone when calling any insurance or healthcare provider because being on hold just seems to be a way of life. It helps to avoid times like Monday mornings or during lunch time because they often have longer wait times during those particular times. I have gotten through to a real live person who does seem to be well-trained and able to answer my questions each time I have called.

My Overall Viewpoint:

BCBS of NC has provided us with quality health insurance, but it is not cheap. I recommend that you take a look at their website and do some cost comparison shopping if you are looking to purchase health insurance individually. I also recommend that you read the fine print and ask any questions that you might have before signing up for a health insurance program. I have been inclined to exercise on a more regular basis and to eat healthier just to get points in the Blue Points program because I have my eye on some of those gift cards. If I have to pay for health insurance, I might as well get what I can back!