I’m primarily considering the two most upper-tier plans (medical + dental, for individual) on offer:
– MetroPlus PlatinumPlus-P2, NS, INN, Family Dental, Family Vision, Dep25, Healthy Living Rewards, Metro-MP
– Healthfirst Platinum Leaf Premier, NS, INN, Dep25, Family Dental, Family Vision, Free Telemedicine, Fitness & Wellness Rewards
Both plans are $0 deductible, $2,000 OOP. About me – I have several significant, chronic health conditions. My health is currently stable but I do need to see 4 different types of specialists at least once a year, one of which is a retina specialist (unsure if this is covered under vision insurance or general medical insurance). I take 8 prescription meds, all of which are popular generics. I may need a transplant (or two) in the future. I may have some ER visits/stays within the year w/ ambulance service, and I do need at least yearly diagnostic scans (echos, MRIs, etc) for several different issues. I do also have significant non-cosmetic dental work that needs done as well. The plans seem fairly comparable in terms of cost and copays for various services – am I missing anything that I need to know? Will be getting new dr’s so don’t need to worry about which specific dr is in-network yet but I do want to have plenty of availability for quality specialists and not long wait times to see them. I’m concerned that none of the marketplace plans seem to offer out of network coverage and that the plans on offer for NYC seem to only have in-network drs/services within the NYC area. I travel quite a bit and am worried that if something happens if I’m out of state, I won’t be covered – is that correct? Thanks!
submitted by /u/LatkesAndWine
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I’m primarily considering the two most upper-tier plans (medical + dental, for individual) on offer: – MetroPlus PlatinumPlus-P2, NS, INN, Family Dental, Family Vision, Dep25, Healthy Living Rewards, Metro-MP – Healthfirst Platinum Leaf Premier, NS, INN, Dep25, Family Dental, Family Vision, Free Telemedicine, Fitness & Wellness Rewards Both plans are $0 deductible, $2,000 OOP. About me – I have several significant, chronic health conditions. My health is currently stable but I do need to see 4 different types of specialists at least once a year, one of which is a retina specialist (unsure if this is covered under vision insurance or general medical insurance). I take 8 prescription meds, all of which are popular generics. I may need a transplant (or two) in the future. I may have some ER visits/stays within the year w/ ambulance service, and I do need at least yearly diagnostic scans (echos, MRIs, etc) for several different issues. I do also have significant non-cosmetic dental work that needs done as well. The plans seem fairly comparable in terms of cost and copays for various services – am I missing anything that I need to know? Will be getting new dr’s so don’t need to worry about which specific dr is in-network yet but I do want to have plenty of availability for quality specialists and not long wait times to see them. I’m concerned that none of the marketplace plans seem to offer out of network coverage and that the plans on offer for NYC seem to only have in-network drs/services within the NYC area. I travel quite a bit and am worried that if something happens if I’m out of state, I won’t be covered – is that correct? Thanks!
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