Any Pennsylvania folks in here? Question about gotchas in exchange plans.

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My sister-in-law in central Pennsylvania is losing her health insurance and asked for my help picking a good plan (her kids are grown, and no more are on the way). I think her best options will be COBRA through her ex-husband’s employer, any group coverage available through the direct marketing firm where she’s an independent contractor, or healthcare.gov (she probably won’t qualify for subsidies). She’s currently looking at faith-based plans and medically underwritten policies, which I’m trying to steer her away from.

Pennsylvania people – do you have any suggestions about what gotchas I should look out for on exchange plans? For example, where I live in Massachusetts, I typically steer people away from Tufts Direct and BMC HealthNet exchange plans due to their restrictive networks. And when I see keywords like “Options” and “HCCS,” I know I’m dealing with a tiered network plan. Massachusetts also has a highly integrated healthcare system – just about every provider and hospital in the state participates with all 4 of the top health insurance carriers – which I understand is unusual.

About all I know about the Pennsylvania health insurance ecosystem is that it’s tricky (how many BCBS companies does one state even need???). Does anyone have any advice about specific insurance carriers to avoid, keywords to watch out for, or suggestions about how to get good and relatively low-cost coverage in the central region of the state? Thanks!!

submitted by /u/BijouWilliams
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My sister-in-law in central Pennsylvania is losing her health insurance and asked for my help picking a good plan (her kids are grown, and no more are on the way). I think her best options will be COBRA through her ex-husband’s employer, any group coverage available through the direct marketing firm where she’s an independent contractor, or healthcare.gov (she probably won’t qualify for subsidies). She’s currently looking at faith-based plans and medically underwritten policies, which I’m trying to steer her away from. Pennsylvania people – do you have any suggestions about what gotchas I should look out for on exchange plans? For example, where I live in Massachusetts, I typically steer people away from Tufts Direct and BMC HealthNet exchange plans due to their restrictive networks. And when I see keywords like “Options” and “HCCS,” I know I’m dealing with a tiered network plan. Massachusetts also has a highly integrated healthcare system – just about every provider and hospital in the state participates with all 4 of the top health insurance carriers – which I understand is unusual. About all I know about the Pennsylvania health insurance ecosystem is that it’s tricky (how many BCBS companies does one state even need???). Does anyone have any advice about specific insurance carriers to avoid, keywords to watch out for, or suggestions about how to get good and relatively low-cost coverage in the central region of the state? Thanks!!
submitted by /u/BijouWilliams [link] [comments]Read Morer/HealthInsurance

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