r/HealthInsurance • u/Starlight-Seeker • Jul 27 '25
Plan Choice Suggestions How Screwed Am I?
My employer is changing from Cigna to Planstin Administration which is apparently something called a reference based pricing plan. What is this? Please explain this to me in the simplest terms possible.
My benefits manager said that before every single doctor's appointment and every single test (labs, x-ray, etc), I'll need to contact Planstin's Care Coordination Team. I have multiple chronic medical conditions. I see a lot of specialists, get a lot tests done, and take multiple prescriptions.
How screwed am I with this type of health insurance?
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u/QuantumDwarf Jul 27 '25
I would run as fast as I could to somewhere else.
There are a lot of what I call snake oil salesmen who think they can ‘disrupt healthcare’ and find a simple solution to lower the cost of care.
One I worked with came up with a brilliant idea that anyone needing MKS surgery should just drive 4+ hours one way to have it done at a lower cost facility. Bypassing literally 10+ providers on the way. Never mind that the facility didn’t have access, or that you have to drive for multiple pre and post appointments or that where I live the winter could make it incredible dangerous to drive that much. He convinced so many people this was a good idea
Healthcare needs a good disruption but this is disruptive to anyone needing care.
The reason your employer is doing this is to save money. That’s all they care about. Saving money so their financials meet their goal of more and more profits for those at the top.
I would run, but then I don’t know the job landscape where you live.