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Less/more comprehensive???
Old 12-09-2013, 04:53 PM   #1
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Less/more comprehensive???

The phrases, less comprehensive and more comprehensive is confusing me. I read phrases when reading about Obama care exchanges.
Do these phrases mean some plans offer more coverage than others or... you have to just pay more in some plans to get the same coverage?

Thanks
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Old 12-09-2013, 06:01 PM   #2
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Generally, in HI industry more "comprehensive" means more covered services and/or better payment for covered services. However, I've always felt "comprehensive" was a nebulous term often thrown around loosely to impress folks about insurance products. Deciding how "comprehensive" any specific insurance product is really depends upon the individual situation, and the relative cost of the plans. It's wasted $$ to pay extra $100/mo ($1200/yr) to add, let's say, vision coverage with a max benefit of $1,000/yr. An HMO plan with a small provider network and no Out-Of-Network coverage may be quite "comprehensive" for young healthy adults with only routine health issues, but not for a complex cancer patient whose experienced oncologist is not part of that HMO network. And while maternity, contraception, and pediatric dental benefits may make a family HI plan significantly more "comprehensive" for a 20-something couple with 2 kids, those features would be useless for a single 60yo man.
IMHO- While Obamacare does require all "qualified" HI plans to meet certain basic requirements, it does not change the need for folks to look carefully at specific HI plans they are considering to see how they fit their individual needs (e.g. premiums, deductibles, OOP max, provider networks, and additional coverages like medical transport).
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Old 12-09-2013, 07:02 PM   #3
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Quote:
Originally Posted by ERhoosier View Post
While Obamacare does require all "qualified" HI plans to meet certain basic requirements, it does not change the need for folks to look carefully at specific HI plans
What does " HI" or "HI plans" mean?

Example: I've read in articles the Bronze is less comprehensive and the Gold is more comprehensive.

I didn't know if that meant you had to pay more for the same coverage with the Bronze. Or you could pay more for the Gold and get better/more coverage.
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Old 12-09-2013, 07:19 PM   #4
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HI = health insurance
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Old 12-10-2013, 08:19 AM   #5
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Quote:
Originally Posted by brownred View Post
What does " HI" or "HI plans" mean?

Example: I've read in articles the Bronze is less comprehensive and the Gold is more comprehensive.

I didn't know if that meant you had to pay more for the same coverage with the Bronze. Or you could pay more for the Gold and get better/more coverage.
Our Bronze plan does not provide less health benefits than the equivalent Gold plan. The difference is solely in the pricing. You play lower premiums, but you have higher deductibles that you have to meet before the insurance starts paying out, and higher max out of pocket limits.

If your medical bills are low, your total cost will be less with a Bronze plan. If your medical bills are high, a Gold plan with its lower copays, deductibles and max out of pocket may be better in total cost. But the Bronze plan, due to it's lower premiums, may come close in terms of total cost even in the worst medical expense scenarios.

You have to do some calculations to compare plans.
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