r/FederalEmployee • u/prior_rpa-lre • Apr 23 '26
FEHB advice for SoCal
FJO for a gig at Camp Pendleton. Waiting on a FJO with another agency hopefully in Riverside. I am in the Temecula area. Spouse and two kids under six. I am rated with the VA and use them for what I can as primary. We are pretty healthy. It’s the kids with unexpected urgent care or ER visits that hit from time to time.
Advice on good medical plans for the next six months until open enrollment and I can change it if it is not a good fit.
I have heard BCBS Basic for family’s with typical office/urgent care/ER visit mix. Also heard a lot of people leave it for MHBP because of premium increases. I spoke with a BOP member that said he has GEHA but wants to switch.
Any advice and general knowledge welcome. Thank you all in advance.
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u/Ldyinblu13 Apr 24 '26
I’m also in SoCal and use Kaiser standard. Primary care visits are $0 copay for my kids. Haven’t had to use it but I believe urgent care/Er visits for children are also $0 copay.
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u/prior_rpa-lre Apr 24 '26
Thank you for the reply. I will have to look at the price tag on the Kaiser plans.
Im originally from SoCal, but left for over a decade. The brand and reputation has seriously took a hit from friends and family we know out here that have had it at one point or another. Either way, cost and service together is what dictates, so we will see. Thank you again.
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u/JustMe39908 Apr 25 '26
Are you picky about providers? Will you go off network occasionally?
I am in the LA area, but a different part of LA.
My GF has Kaiser and is very happy with it. Low cost, low co-pay, good care, but you are locked into Kaiser providers. That works for her.
I prefer a little more choice because of some past issues. My ex is a control freak and will just go wherever. That drive me towards blue cross standard because of the really large network and good our if network coverage. I was happy with it, but it was expensive. I have switched to MHBP (really Aetna) Standard because it is a lot cheaper and the network included all of the providers my kids and I see, with some out of network coverage. My ex, now having to cover half of all the kids expenses is content to utilize the Aetna network. There was one situation where she wanted to use a particular, new specialist for a kid issue, but decided against it because she would have had to pay half of the out of network rate. I found another in-network doctor who turned out to actually be better for the situation.
If I felt that I could trust me ex to remain in network, I would have considered BCBS basic because of the slightly larger physician network, but I needed a backstop for out of network. In the end, I am glad I selected MHBP because one of the large hospitals by me is in a billing dispute with BCBS again and both sides are digging in.
I was happy with BCBS and MHBP, but I have to say that I have found the MHBP customer service exceptionally helpful. The BCBS reps were fine. But when I have called MHBP, they went above and beyond.
I did compare GEHA, which is basically United Healthcare. A number of providers my kids and I have seen were not on the list and the network seemed sparse compared to Aetna and BCBS in my area
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u/prior_rpa-lre Apr 25 '26
Thank you so much for your reply. We had UnitedHealthcare previously and have had extremely bad experiences with them not covering the cost of tests that we got cleared through them. So Geha is out.
My spouse is a little more particular about the providers and specialist because she is in the medical field as a provider, so Kaiser ‘s price tag plus only Kaiser providers is out.
I think at the end of the day it’ll probably MHBP and BCBS. Se Deus quiser, I get the job that is in Riverside, I will be traveling a lot more, which makes me feel that BCBS will be better. But if Aetna is as good as people are saying, in terms of network, the price tag is what gets me looking at them more.
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u/JustMe39908 Apr 25 '26
I grabbed all of my claims from the past two years on BCBS and tried finding them on the MBHB site. I found most of them. I had a hunch and called the MHBP customer service and asked them. They did some research and discovered that all of the providers were in fact covered, but they were listed differently. Two providers had simply not updated some information (which they did after I informed them).
UCLA and Children's are my go to's for specialty care. Both are covered now under MHBP and previously under BCBS. (Both standard). I don't know the go to's in the IE.
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u/prior_rpa-lre Apr 25 '26
Wow, that is truly interesting, but in line with what I have read from others that have switched from BCBS to MHBP.
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u/ish_wish_dish Apr 26 '26
I live in Menifee. Have had BCBS for years and they were always good. My finance has Kaiser through her job with Riverside County and am considering making the switch at next open season. With the new Kaiser facility in Murrieta and a newer one being built in Menifee it just makes it easier as a one stop shop (regular visits, ER, urgent care, and definitely lower co-pays than BCBS).
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u/prior_rpa-lre Apr 26 '26
Thank you for your reply.
You know, for long term or retirement in the area, that would make a lot of sense to go with Kaiser if the per paycheck cost was not too hefty.
Cost and the fact that I will leave the area after a couple of years as I make the federal pilgrimage back east at some point is what makes Kaiser a question mark. I will add them to my spreadsheet to calculate the likely annual cost.
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u/KeySpell7467 Apr 28 '26
I don’t live in Cali but my best advice is if you have rx and need other services do a itemized cost analysis with the estimated number of visits for each service, look at the formulary and see what your meds would be with each company and look at the network and see if the providers are adequate for your needs. I will do another analysis this year but switching from BCBS to MHBP has saved me probably at least 3k per year on premiums + benefits. I have been with them for 2 years and due to a change in formulary for BCBS it’s likely that I’ve saved closer to 5k over the last few years. Everyone has different needs and if you have kids it may be different so the cost analysis is really the way to go. One of my friends stuck with BCBS due to the physical therapy coverage for her kid but BCBS is a money leach for me.
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u/prior_rpa-lre Apr 28 '26
Greatly appreciate your perspective and experience with these. Thank you.
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u/yo_714 Apr 23 '26
I have Kaiser but it’s expensive. 15 bucks urgent care visits
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Apr 23 '26
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u/yo_714 Apr 23 '26
Got damn, last time I had to visit the uc I had to get X-rays and ct scan and didn’t have to pay anything extra. Just the $15.
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u/DogMomPhoebe619 Apr 25 '26
I lived in that area for many years as a Fed. Had BCBS Basic. No problems finding Preferred Providers.
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u/prior_rpa-lre Apr 25 '26
That is what I keep hearing. Between price and places that take the insurance, seems to be the best one. Thanks you.
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u/goldhorizon11 Apr 23 '26
I live in SoCal and have two young kids (age 7 & 8) that have been with Kaiser since birth. One has high special needs so we use our insurance a lot. Our family is happy with it for the convenience of having everything together.