Join Early Retirement Today
Thread Tools Search this Thread Display Modes
"Minimum Coverage" PPO Plan
Old 12-08-2014, 02:19 PM   #1
Thinks s/he gets paid by the post
Join Date: May 2008
Posts: 2,735
"Minimum Coverage" PPO Plan

My 2014 Bronze PPO plan from Covered CA will no longer be offered in 2015 through Covered CA.

Instead, if I want the same plan, I can enroll directly through the insurer, at a higher cost, approximately 20% more than my 2014 premiums.

That's just so I can keep my same doctor/medical group (though they are in negotiations with the insurer to remain on their PPO network).

So I went to the insurer's site, entered my zip code and entered my birthdate and one of the plans they offer is a "Minimum Coverage" PPO Plan which has much lower premiums, approximately $130 less than the Bronze PPO Plan for 2015.

It has a higher deductible, $6600 vs. $5000, as well as higher out of pocket max, $6600 vs. $6250.

But the first 3 office visits are "free" meaning the plan would pay for them? It also has the preventive care, which seems to be separate from the first 3 free visits (which could also be urgent care visits, not routine office visits):

So the savings on the premiums are the primary draw for me. I also have been averaging a couple of doctor's visits per year for a long time, have no active prescriptions.

But I thought these kinds of bare bones, below Bronze-level coverage, only applied to people under 30 years of age or some other categories? Wondering whether the insurer's site is correctly presenting "legal" (compliant under the ACA) plans.

When I go to, they only show me strictly the metal plans.

If my needs for medical services remain consistent with recent history, 3 "free" visits (again, still not certain about this one) are in some ways better than what's offered under the Bronze plans.

The only bummer is that none of the plans offered by the insurer are HSA-eligible so I may in the end have to get a higher-premium plan just to get the HSA advantages.

explanade is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 12-08-2014, 03:13 PM   #2
Thinks s/he gets paid by the post
Join Date: Jul 2012
Location: Mississippi
Posts: 1,825
As I recall when looking there wasn't much difference between bronze and catastrophic
Compare the Cheapest Health Insurance Plans: Bronze vs. Catastrophic - US News

I would guess it didn't filter correct for you at the insurers site vs coveredCA.

My bronze plan has 3 "free" PCP visits with a deductible just below the $6600 limit. I imagine the slightly lower deductible changes the actuarial value just enough to classify it as bronze versus catastrophic.

rbmrtn is offline   Reply With Quote
Old 12-08-2014, 06:00 PM   #3
Thinks s/he gets paid by the post
Join Date: May 2008
Posts: 2,735
The Bronze plans do not offer free PCP visits as far as I can see.

If you get 3 visits (either PCP or some urgent care visits) as well as the preventive care, it might be enough for some people in good health.

It's interesting, one of the PDFs that you can download for this "Minimum Coverage" PPO plan says "Catastrophic" in the file name.
explanade is offline   Reply With Quote
Old 12-08-2014, 06:05 PM   #4
Thinks s/he gets paid by the post
gauss's Avatar
Join Date: Aug 2011
Posts: 1,451
I would want to see if the minimal coverage plan is ACA compliant in writing.
gauss is offline   Reply With Quote

Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off

Similar Threads
Thread Thread Starter Forum Replies Last Post
Question on Medicare vs private Medicare PPO Ready Health and Early Retirement 9 05-20-2014 12:48 PM
Medicare HMO vs PPO heirloom Health and Early Retirement 11 11-09-2013 05:45 PM
Medical Insurance - CDHP vs PPO Sanity Check Request prototype Health and Early Retirement 2 10-26-2013 02:10 PM
PPO,POS,or HMO??? aaronc879 Health and Early Retirement 17 02-08-2012 03:30 AM
Minimum Income Tax/ Simple IRA ferco FIRE and Money 1 06-18-2005 07:15 AM


All times are GMT -6. The time now is 08:48 PM.
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2016, vBulletin Solutions, Inc.