So first and foremost I’m a health/life broker, but individual/family plans are not my main market, only 15% of my book, most of what I do is medicare. I’m asking mainly to see if any other experts can help me help my client.
We’re in CT. Household is Mom and Daughter, they are on a heavily subsidized ACA plan through our local state run exchange, but they don’t qualify for CSR’s. We only have 2 carriers on our exchange, 1 is a local carrier Connecticare, the other is BCBS, but all of our on exchange BCBS plans utilize local networks, they don’t leverage the BCBS national networks. So everything out of state is out of network.
Daughter goes to college out of state in GA and Mom is upset that the plan for Daughter effectively has no out of network coverage until Daughter hit the individual OON deductible which is $8600. where she then pays 40% co-insurance up until her individual OON MOOP $17100.
Since the daughter is effectively living in Georgia more than half of the year would she be eligible for a Georgia based plan? I’m assuming not unless she formally changed her resident state and files taxes independently from her mom?
I know some schools offer plans for students, which i’m having Mom look into.
Is there anything i’m missing?
submitted by /u/flying_unicorn
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So first and foremost I’m a health/life broker, but individual/family plans are not my main market, only 15% of my book, most of what I do is medicare. I’m asking mainly to see if any other experts can help me help my client. We’re in CT. Household is Mom and Daughter, they are on a heavily subsidized ACA plan through our local state run exchange, but they don’t qualify for CSR’s. We only have 2 carriers on our exchange, 1 is a local carrier Connecticare, the other is BCBS, but all of our on exchange BCBS plans utilize local networks, they don’t leverage the BCBS national networks. So everything out of state is out of network. Daughter goes to college out of state in GA and Mom is upset that the plan for Daughter effectively has no out of network coverage until Daughter hit the individual OON deductible which is $8600. where she then pays 40% co-insurance up until her individual OON MOOP $17100. Since the daughter is effectively living in Georgia more than half of the year would she be eligible for a Georgia based plan? I’m assuming not unless she formally changed her resident state and files taxes independently from her mom? I know some schools offer plans for students, which i’m having Mom look into. Is there anything i’m missing?
submitted by /u/flying_unicorn [link] [comments]Read Morer/HealthInsurance