Our office is getting quotes regarding switching insurance. Currently we have a BCBS Selectchoice program where we have to pick a local clinic or pay higher fees for out of network providers. We also pay 20% of drug costs plus $15 (one month) or $30 (2-3 month) copay with out of pocket max of $1000 then just pay copays of $15 or $30
They're looking at switching to medica which would allow for us to go out of network -- not have to pay extra for travelling to the City for ENT and ID appointments. However, medica's drug program is on a tier system and it looks like Tobi & Pulmozyme would be specialty pharmacy with $200 per month each, plus maybe coinsurance -- wasn't clear on that or their out of pocket max... Also I assume creon being a name brand is also a higher tier medication...
I've heard locally of companies switching to medica for a better rate, but then switching back to BCBS. Any thoughts...? Experiences with Medica?
They're looking at switching to medica which would allow for us to go out of network -- not have to pay extra for travelling to the City for ENT and ID appointments. However, medica's drug program is on a tier system and it looks like Tobi & Pulmozyme would be specialty pharmacy with $200 per month each, plus maybe coinsurance -- wasn't clear on that or their out of pocket max... Also I assume creon being a name brand is also a higher tier medication...
I've heard locally of companies switching to medica for a better rate, but then switching back to BCBS. Any thoughts...? Experiences with Medica?