Friday, September 6, 2013

Obamacare exchanges aren't the only game in town

Americans who buy their own health insurance next year won't have to get coverage through their state-based exchange.

Many insurers will offer individual policies outside the Obamacare exchanges in 2014. Consumers can avoid the exchanges by buying plans directly from insurers or through brokers.
But should they?
First, anyone earning less than 400% of the poverty line will be eligible for federal subsidies toward exchange-based plans, so going off the exchange would likely not make sense.
But those who make too much to qualify for subsidies should look both on and off the exchanges for a plan that best fits their needs, experts say.
The off-exchange policies are required to have many of the same Obamacare protections as plans sold on the exchanges, like maternity and mental health benefits, plus insurers can't exclude enrollees because of pre-existing conditions. Only a handful of current individual policies that meet strict guidelines will be grandfathered in.
So why might one want to go off the exchange?
#1: Possible better coverage: Some insurers may opt to offer richer policies or continue grandfathered plans off the exchange to hold onto long-time customers. These policies may have more comprehensive doctors' networks or lower drug co-pays ... with a higher premium to boot, said Dan Mendelson, chief executive of Avalere Health, an advisory company for insurers. But they could be more attractive to current customers than the exchange policies, which may be more restrictive in order to keep premiums under control.

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