Hi,
I’m hoping someone might be able to help me out with a question I have about healthcare plan selection. I’m self employed and I’ve had an off-exchange plan since 2017 that costs $522/month and I live in California. With the instability in my income that’s resulted from covid, I thought it might be a good idea for me to take a look at whether or not I qualify for any subsidies through Covered CA. I filled in all the info to the best of my abilities and the most similar Silver PPO plan that I found offered by Blue Shield of CA is listed as $600/mo. It appears that I don’t currently qualify for any subsidies and I likely won’t unless my income decreases substantially.
I compared the two plans and they appear to be very similar with the exception of the deductible which is around $1,800 on my current plan and $4,000 on the on-exchange plan which is counterintuitive. I’m really not seeing any benefit to purchasing the “on-exchange” $600/mo plan since it appears to cost more and have a higher deductible with everything else that I can see appearing to be about the same.
So my question is, is there something that I’m not seeing/understanding? Is there some major drawback to sticking with my $522/mo Silver PPO plan that I’m not currently aware of that will only become evident when I have a medical emergency?
I did try to do some research and it seems from my research that all plans regardless of whether they are purchased on or off exchange must comply with certain basic consumer protection regulations as outlined in the ACA. However, it looks like there is an additional layer of consumer protection regulated at the state level which designates plans as “Qualified Health Plans”. Evidently, off-exchange plans are not required to be QHP. I plan on calling Blue Shield tomorrow to see if I can get a clear answer out of them regarding whether or not my plan is QHP in CA, but if history is any indication I have a feeling they may not answer my question clearly/directly. So if anyone has any clarification to provide about the quality of off-exchange plans in CA, I would appreciate any input. Thank you for reading all of this!
submitted by /u/BootyThunder
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Hi, I’m hoping someone might be able to help me out with a question I have about healthcare plan selection. I’m self employed and I’ve had an off-exchange plan since 2017 that costs $522/month and I live in California. With the instability in my income that’s resulted from covid, I thought it might be a good idea for me to take a look at whether or not I qualify for any subsidies through Covered CA. I filled in all the info to the best of my abilities and the most similar Silver PPO plan that I found offered by Blue Shield of CA is listed as $600/mo. It appears that I don’t currently qualify for any subsidies and I likely won’t unless my income decreases substantially. I compared the two plans and they appear to be very similar with the exception of the deductible which is around $1,800 on my current plan and $4,000 on the on-exchange plan which is counterintuitive. I’m really not seeing any benefit to purchasing the “on-exchange” $600/mo plan since it appears to cost more and have a higher deductible with everything else that I can see appearing to be about the same. So my question is, is there something that I’m not seeing/understanding? Is there some major drawback to sticking with my $522/mo Silver PPO plan that I’m not currently aware of that will only become evident when I have a medical emergency? I did try to do some research and it seems from my research that all plans regardless of whether they are purchased on or off exchange must comply with certain basic consumer protection regulations as outlined in the ACA. However, it looks like there is an additional layer of consumer protection regulated at the state level which designates plans as “Qualified Health Plans”. Evidently, off-exchange plans are not required to be QHP. I plan on calling Blue Shield tomorrow to see if I can get a clear answer out of them regarding whether or not my plan is QHP in CA, but if history is any indication I have a feeling they may not answer my question clearly/directly. So if anyone has any clarification to provide about the quality of off-exchange plans in CA, I would appreciate any input. Thank you for reading all of this!
submitted by /u/BootyThunder [link] [comments]Read Morer/HealthInsurance