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Old 05-19-2017, 03:55 PM   #21
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Originally Posted by Sarah S View Post
I think the MAhealthconnector is relatively easy to navigate and you can browse plans now.

I do not believe you can buy individual plans direct from the insurers in MA. It looks like you can when you go to the website but when you start you get redirected to the exchange. So your choice is connector ( exchange ) or Cobra

I also think your choice of plans gets more limited if you are claiming cost sharing That may not matter to you but be aware there is a lot of difference in provider networks among plans and tufts has 2 types - premier which is the normal network and direct which is limited Neither my pcp nor my one specialist takes direct neither do the specialists I would pick if I developed issues. Some of the direct doctors are great but you might not get your top choice
You're right about the Tufts plan. My agent said to take the Tufts Direct and save almost $300 per month over Neighborhood Health and with the $3600 per year savings you can go to a doctors visit that isn't covered and just pay for a physical etc. from this savings and still be ahead
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Old 05-19-2017, 04:41 PM   #22
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True but what if you need surgery or expensive treatment and the doctor you want is not covered? It is not the planned or minor things, it is the big ones and 3600 will not take you far especially if you are paying list price.

As a retired internist I know who I would want for various serious events. Most of them don't take direct. There was thread quite recently with someone in another state who needed spine surgery. None of the doctors she wanted took her insurance.

Direct is probably fine because you will probably be fine. I am not willing to gamble even though I too would be better financially to pay for my current usage of non Direct providers in cash. It is the what if. YMMV
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Old 05-19-2017, 04:59 PM   #23
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True but what if you need surgery or expensive treatment and the doctor you want is not covered? It is not the planned or minor things, it is the big ones and 3600 will not take you far especially if you are paying list price.

As a retired internist I know who I would want for various serious events. Most of them don't take direct. There was thread quite recently with someone in another state who needed spine surgery. None of the doctors she wanted took her insurance.

Direct is probably fine because you will probably be fine. I am not willing to gamble even though I too would be better financially to pay for my current usage of non Direct providers in cash. It is the what if. YMMV
You make a good point. What have you heard about Neighborhood Health plan?
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Old 05-19-2017, 05:09 PM   #24
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My state has its own exchange and it is easily the most benighted, incompetent organization it has ever been my misfortune to deal with (and I say that as a taxpayer and former regulator). Without the help of my agent I think I would have firebombed the exchange headquarters by now. The help is free, so make sure they are competent and take advantage of it.
I agree. Whenever I call I get someone else that doesn't really understand the process. They don't understand the concept of Adjusted Gross Income, and it's frustrating.

For instance I get Rental Income, and I'm pretty sure I'm allowed to use the Depreciated Income from that, which is much lower than the gross or net proceeds but they have a hard time with that.
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Old 05-19-2017, 05:17 PM   #25
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I checked my choices for general surgery and neurosurgery on the NHP website and they were listed so it looks better than direct at a quick glance. I would take a good look though and imagine what hospitals and specialists you might want in various scenarios.

If you take any medications try to find what send away pharmacy you have to use.
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