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Individual policies not in the exchange
Old 10-01-2013, 01:13 PM   #1
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Individual policies not in the exchange

Insurance polices not in the exchange program for your state. Do these policies even though they are not offered on the exchange have to have the same basic criteria as the exchange policies? Example: Pre-existing conditions, limit on out of pocket costs, lifetime coverage, mental health coverage, etc. etc. In other words do all policies whether in the exchange or not have these same protections.
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Old 10-01-2013, 02:09 PM   #2
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Insurance polices not in the exchange program for your state. Do these policies even though they are not offered on the exchange have to have the same basic criteria as the exchange policies? Example: Pre-existing conditions, limit on out of pocket costs, lifetime coverage, mental health coverage, etc. etc. In other words do all policies whether in the exchange or not have these same protections.
See lists here of what all policies, whether on or off the exchange, must include: ObamaCare Health Insurance Rules, Regulations and Standards
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Old 10-01-2013, 02:58 PM   #3
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Insurance polices not in the exchange program for your state. Do these policies even though they are not offered on the exchange have to have the same basic criteria as the exchange policies? Example: Pre-existing conditions, limit on out of pocket costs, lifetime coverage, mental health coverage, etc. etc. In other words do all policies whether in the exchange or not have these same protections.
I believe all policies after 2014 must the essential health benefits. Only the exchange policies are eligible for the subsidy
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Old 10-02-2013, 09:40 AM   #4
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So, the open enrollment period from Oct 1, 2013 to Mar 31, 2014 is only for the Marketplace Exchange right?

For example, if one when to a private insurer such as BCBS in May and wanted to buy, then that's still doable?

The answer probably should be obvious but the light bulb just turned on that we don't have to go through the exchange and wait..and wait. and wait.
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Old 10-02-2013, 10:26 AM   #5
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So, the open enrollment period from Oct 1, 2013 to Mar 31, 2014 is only for the Marketplace Exchange right?

For example, if one when to a private insurer such as BCBS in May and wanted to buy, then that's still doable?

The answer probably should be obvious but the light bulb just turned on that we don't have to go through the exchange and wait..and wait. and wait.

But remember that there will still be time-consuming application procedures for non-Exchange indiv policies, and penalties (sorry, TAXES per SCOTUS) will still apply if you go without HI for part of 2014. Obama suspended the HI mandate for large corporations but NOT for individuals.
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Old 10-02-2013, 10:45 AM   #6
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So, the open enrollment period from Oct 1, 2013 to Mar 31, 2014 is only for the Marketplace Exchange right?

For example, if one when to a private insurer such as BCBS in May and wanted to buy, then that's still doable?
Sure, you can buy an individual policy on the open market like always. Subsidies are only available for the exchange sold policies. Also you can file for exemption for various reason. If the costs for HI is more than 8% of income ( that should be easy for most) for example. 3 month gaps are allowed also. The penalty is prorated based number of months of coverage.

The Requirement to Buy Coverage Under the Affordable Care Act | The Henry J. Kaiser Family Foundation
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Old 10-02-2013, 10:59 AM   #7
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Thx for the replies. It's not my plan to test the date limits , but hearing the dates Oct 1 - Mar 31 almost made me think that once Mar 31 comes around, everything closes.

p.sl This Marketplace thing reminds me of the days when AOL was a big player in the "world wide world" for common folks. What? one can get internet access outside of AOL?
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Old 10-02-2013, 11:12 AM   #8
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Mar 31 is just the close of open enrollment on the exchange. After that the exchange policies are only available with qualifying event until next enrollment.

Hey, I was a compuserve user , and BBS user with a super expensive HST 9600 baud modem before AOL ever showed up
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Old 10-02-2013, 11:26 AM   #9
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My newspaper said only 2 insurance providers are participating in the exchange but named 2 other providers that will offer individual insurance but just not through the exchange. I wonder what those two companies perceive the benefit to be by doing this. Is it maybe hopeful that the sick or unhealthy people who are in need of insurance gravitate toward the exchange due to its more prominent exposure, thus not finding them to enroll in one of their plans? There has to be a reason for this that benefits them, I would have to assume.
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Old 10-02-2013, 11:48 AM   #10
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My newspaper said only 2 insurance providers are participating in the exchange but named 2 other providers that will offer individual insurance but just not through the exchange. I wonder what those two companies perceive the benefit to be by doing this. Is it maybe hopeful that the sick or unhealthy people who are in need of insurance gravitate toward the exchange due to its more prominent exposure, thus not finding them to enroll in one of their plans? There has to be a reason for this that benefits them, I would have to assume.
Hard to know what they are up to but I'm sure it's to their benefit. In my location, one carrier has about 80% of the market and has decided not to play in the exchange ( for now ). It's BCBS which at the national level claims to be a big player and is planning on offering one of the nationwide plans scheduled to come out later.
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Old 10-02-2013, 11:54 AM   #11
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Multi-state plans were announced yesterday. Nation-wide coverage, initially available in 30 states and DC. OPM Multi-State Plan Program Fact Sheet
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Old 10-02-2013, 11:57 AM   #12
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Hard to know what they are up to but I'm sure it's to their benefit. In my location, one carrier has about 80% of the market and has decided not to play in the exchange ( for now ). It's BCBS which at the national level claims to be a big player and is planning on offering one of the nationwide plans scheduled to come out later.
Though I do not understand BCBS nationwide, as they I guess are just a "loose confederacy" at best. But here in MO they are going all in. I just went to their website to see what it would cost next January as I have had them as my carrier until Oct. 1 when I dropped them to sign on with another carrier that will keep me protected from the rate shock until Jan. 2015. Well after looking at the premiums, I know why they were dropping my plan Dec. 31. They wanted to re enroll me into a worse plan but change my premium from $88 to $300! OVER THREE TIMES what I pay now. The media scare hype was correct...If you are a healthy male in an underwritten plan you are going to be hammered!
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Old 10-02-2013, 12:42 PM   #13
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Mar 31 is just the close of open enrollment on the exchange. After that the exchange policies are only available with qualifying event until next enrollment.

Hey, I was a compuserve user , and BBS user with a super expensive HST 9600 baud modem before AOL ever showed up
Ah , good old compuserve. I remember getting my first 1200 baud modem and thinking "I'm really cookin' now"
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Old 10-02-2013, 03:27 PM   #14
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I am reading about the OPM Multi State Program, but I can't say I fully grasp it. All the articles I am pulling up are talking more of the mechanics of how it must adhere to State guidelines and certain oversight of the OPM, but not much detail as to how this effects the consumer in terms of coverage and providers available with it. It's restrictiveness or benefits.

Anyone know of any articles that lay this information out?
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Old 10-02-2013, 09:02 PM   #15
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Multi-state plans were announced yesterday. Nation-wide coverage, initially available in 30 states and DC. OPM Multi-State Plan Program Fact Sheet
Looks like I might be moving. Now if I could only figure out how to shop when I don't live in a particular state. Unfortunately, my favored states are not on the list. I might wait it out.
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Old 10-02-2013, 09:18 PM   #16
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Ah , good old compuserve. I remember getting my first 1200 baud modem and thinking "I'm really cookin' now"
Modem? My 1st PC didn't even have a hard drive.
And my 1st college computer class had us writing programs in FORTRAN 66 using punch cards.
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Old 10-02-2013, 09:22 PM   #17
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Modem? My 1st PC didn't even have a hard drive.
And my 1st college computer class had us writing programs using punch cards.
The first PC in our family was an old TRaSh-80 color computer we had when I was in high school (I think we bought it in 1980 or 1981). Not just any TRS-80 CoCo, but the EXPANDED version with 16K of RAM instead of only 4K! Cassette tape, baby, I stored the programs I wrote on cassette tapes. I had to write down the approximate beginning and end of each program according to the counter on the cassette recorder, add a few seconds of gap between each program I saved and fast forward to the gap just before the program I wanted to load....

I largely have that machine to blame for my choosing a computer science major.
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Old 10-02-2013, 09:25 PM   #18
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Looks like I might be moving. Now if I could only figure out how to shop when I don't live in a particular state. Unfortunately, my favored states are not on the list. I might wait it out.
Funny you should say that, because I seem to be facing a similar challenge, living in the wrong state. We can't wait until it sorts itself out but I am confident that I will find a way.
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Old 10-02-2013, 09:26 PM   #19
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Modem? My 1st PC didn't even have a hard drive.
And my 1st college computer class had us writing programs using punch cards.
Yea we get to skip that, the card reader was broken. Our challenge was to write the program in machine code. You know
X'D204040C05CC' some kids had a problem.

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Old 10-05-2013, 09:02 AM   #20
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I made my move for 2014 and decided to leave my grandfathered BCBS HSA coverage (gulp...) for a BCBS Bronze Choice PPO HSA with a $6K deductible for single person, 100% coverage after that. (Simple, no medicaid, no subsidy, and no signup through the blackhole marketplace. New premium is about $30/month less than present).

I did the application with my health insurance agent yesterday. Signed, submitted, delivered and now just waiting for the welcome kit.

It was interesting talking to my agent from her perspective as things are just as crazy (or more) from her end. She was telling me how she had a vacation with her husband in Arizona but ended up ruining the vacation by having to connect and do w*rk stuff constantly during vacation..

.... Ah..it's nice to to be retired
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