Have you had both Blue Cross/Blue Shield and for-profit health insurance?

If so, did you notice any difference?

Some BC/BS entities are now profit, some are still non-profit. What I really want to know is whether the non-profit BC/BS actually works for the consumer or for the benefit of upper management.

They have a ridiculously low cap on necessary medical equipment.

You end up having to pay most or all of it out of pocket.

Your employer (or you, if you are in MA and have individual coverage) chooses the plan details including copays and max benefits.

that was before it turned from non-profit to profit. When that change happened the name BC/BS still carried the good will in its name that it had when it was a non-profit. A lot of people - myself included bought BC/BS because of its good reputation when it was a non-profit. Now as an insurance company - it really sucks - because it is in the business to deny, deny, deny - and make as much money for the biz as possible. Last year I got two premium raises in a row. If I have to use any aspect of the plan I'm in I have to call first - and they tell me where to go and what I can and can't do.

We have Blue Point now. I never used to mind BC/BS until I was on Aetna for a while--Aetna cost pennies and didn't care that my primary doctor was a holistic m.d. (I paid for my office visits out of pocket.) When we switched to BC/BS, the stupid company called me continually and threatened to drop me off my husband's coverage if I didn't pick a "real" doctor (one on their list). So I got a "medical beard" who I never go to and still see my holistic m.d. Asshats. x(

They pulled every dirty trick they could on me...pre-existing conditions, saying my doctor was out of network (even though it was a PPO and by the very definition there was no network), saying I omitted stuff on my application (it was work insurance...there was no detailed medical history application to fill out :crazy: )

I had their PPO for a couple of years, and they fucked me on copays, prescriptions, out of pocket costs. :argh: I spent more time on the phone with them yelling at them to do their jobs than I did at my job at one point.

Luckily, I switched jobs, and I have UHC now, and they are the best. Never deny me anything or ever give me a hard time.

I have BC/BS of Texas (their HMO, called "HMO Blue") and I have had no problems.

I believe BC/BS of Texas is now for-profit, but I'm not sure.

About the only thing I don't like about it is the cost -- $600 per month for my spouse and me, but that's mostly due to my employer's cost allocation (lower-paid workers at my company don't pay near that much).

As for the care, it's great. It's an HMO, so there are few if any policy limits on what they pay. I do have to go through a "gateway" primary care physician, but that's not a big deal, and if I need to see a specialist, the BC/BS network is so large it's easy to find one.

Personally, I think the large BC/BS-style HMO is a decent model -- some HMOs suck, because they aren't large enough to really encompass enough doctors, specialists, etc., and therefore your choice is severely limited. BC/BS is able to do a much better job without restricting choice too much, IMHO.

Beware them...the very first thing they did when my company switched, was to tell me I had to pay full price for all of my prescriptions from then on because my high cholesterol was a pre-existing condition that they did not have to cover. And it just got worse from there. Wouldn't cover my doctor, told me that the surgery for my sinuses was unnecessary and they would not cover it. I had to actually lawyer up to get them to pay up for that.

I got the cobra offer after I quit, and couldn't believe that my company was paying 850 a month for that pile of shit.

The only difference I have seen is BCBS doesn't disallow as many medicines or procedures.

In one company I worked in, when we were all shoved into Kaiser-Permanente, an HMO, upper level executives were given Blue Cross as one of their perks. Frankly, insurance started getting out of control in the early eighties when they were allowed to start bringing in huge deductibles and other abuses that became apparent like ridiculous executive compensation. This doesn't mean it was working. There were still large segments of the uninsured who didn't get adequate health care or none at all. I went to school with many kids who were never taken to the doctor because their families were too poor. If they got sick, they had to tough it out with home remedies and I remember some dying of what was explained by teachers as a fever. Usually, parents would finally take the kid to the ER when in panic mode but it was too late to save them by then. Even though at that time the County Hospitals would have given them care, at that time there was a stigma felt by these families about taking charity or welfare as it was viewed. This is another reason that health care should be universal. When everyone rich or poor gets the same quality basic care, and pay into according to their ability, there is no stigma attached to it.

I don't notice any difference between BC/BS and the for profit health insurance I have now. BC/BS acts just like a for-profit insurer.

They are for-profit in lots of states now.