Kaiser HMO or BCBS PPO?
Hey, I am enrolling in a health care plan for the first time myself. I have the option of paying $1800/year for Kaiser HMO or $2660/$2350 a year for blue shield blue cross at 750 or 1000 deductible. I have 2000/5000 HDHP options but I assume I have doctor visits too too often and my prescriptions are too costly for those options.
I'm a mid 20's guy with crohn's disease in remission and narcolepsy. I probably average seeing a specialty doctor 8 times a year just so I can refill prescriptions. The main prescriptions I take are cequa, modafinil and mesalamine. Cequa is the only one that doesn't have a generic version that I'm worried about. From Kaiser's prescription formulary it says Cequa is tier 4 with no restrictions but my company's description doesn't have a tier 4 or 5 cost for this medicine so i'm not really understanding how much it could cost. It says it would cost 30% for tier 3 though, so I would most likely reach an OOP maximum of $1500 if I got it every month for a year. BCBS says Cequa is NF so I'm guessing I would also need to reach an OOP maximum to get that covered as well.
submitted by /u/bongdong42O
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