Your own health insurance when going DPC or concierge

[FrustratedFamDoc]

Besides receiving coverage through a spouse’s plan, what are you guys doing as far as a catastrophic plan since they are illegal for anyone over 30?

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[VA Hopeful Dr]

Get on healthcare.gov and get the absolute cheapest plan you can find. Basically the same as a catastrophic plan but includes preventative stuff.

 

[FrustratedFamDoc]

I’ve never looked, but with our income level, do we even qualify for a marketplace policy?

 

[KaiBuzz]

You qualify but won’t be eligible for subsidies. You’ll pay the full premium.

 

[AMEHigh]

I’ve never looked, but with our income level, do we even qualify for a marketplace policy?

Yes, anyone can buy a plan from the marketplace. It’s not like Medicaid where you have to qualify with a certain income. For people with lower incomes they do get subsidies to help offset the cost.

 

[FrustratedFamDoc]

any idea what the network coverage is for these policies? My hospital system pretty much takes everything and I’ve lost patients due to coverage changes when they went on marketplace.

In an emergency, you don’t always get to choose your facility.

 

[AMEHigh]

any idea what the network coverage is for these policies? My hospital system pretty much takes everything and I’ve lost patients due to coverage changes when they went on marketplace.

In an emergency, you don’t always get to choose your facility.

You just need to look at the plan options available to you. It can vary by state. My partner had a market place plan through blue cross blue shield and it was pretty much like a regular plan you’d get through an employee and he seemed to have decent coverage. Thankfully now in the state I live in domestic partners can be added to insurance so he’s now on my insurance.

I looked at marketplace plans through my current state and unless you were going to pay more than $1,000 a month for 1 person the options seemed to be more ****ty in regards to coverage and seemed to be the plans that my front desk people and billing department and patients complain about having to deal with cause they don’t cover anything.

So yeah, it really varies.

 

[hallowmann]

any idea what the network coverage is for these policies? My hospital system pretty much takes everything and I’ve lost patients due to coverage changes when they went on marketplace.

In an emergency, you don’t always get to choose your facility.

These are wildly variable by state and even region within states. In places with virtually no market competition (think areas where the insurance companies paid off politicians to be the only places in town or with such poor healthcare that other companies left because they couldn't profit), you'll find crappier coverage for more money. In places actually functioning like the marketplace was intended to, you'll find a large range of options from a cheap bronze plan/HMO to an expensive platinum PPO that's accepted everywhere. I was shocked to see that when I moved from a place with LCOL to a more densely populated place with HCOL, marketplace insurance premiums were one of the few things that actually got much cheaper/better.