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purchase through state exchange or
Old 07-23-2015, 09:36 AM   #1
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purchase through state exchange or

Hi everyone,
I'm wondering if anyone knows of any pros/cons to purchasing health insurance through the MD state exchange vs. Here are the basic facts:

1. I'm starting a pre-FIRE test run by taking an unpaid leave of absence for 1 year, starting next month (whoo-hoo! I don't really plan to go back after a year, but the option will be there). So I will be losing employer coverage (COBRA cost is insane).
2. As far as I can tell, the plans/costs are the same in the MD state exchange and
3. I won't get an ACA subsidy this year, but I probably will next year, so next year I will go through the state exchange for the subsidy.

Thanks for any insights....

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Old 07-25-2015, 01:58 PM   #2
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Given #3, if the plan you want this year is on both, I would apply on the exchange in order to go through the application process only once. Then it would be easier to edit the income field (and possibly plan choice) next year.

Good luck with the LOA.

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Old 07-26-2015, 01:32 PM   #3
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We had this scenario this year (no subsidy, but expecting to qualify for one next year) and decided to just go off-exchange. It seemed like it was much easier to sign up via the insurer's web site directly. Of course, to gamecock's point, that just kicks the can down the road a bit. Sigh.
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Old 07-26-2015, 01:37 PM   #4
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I currently have a grandfathered plan direct w/ the insurance company, but it will expire in December of this year. So I will have to make a choice later this year.

I haven't personally compared plans between an exchange and insurer-direct, but I have heard that the networks listed on the exchange plans may be substantially different than those offered in plans sold direct from the insurance company, so make sure you check every i and every t to make sure you're comparing apples to apples.

Even though you are likely going to get a subsidy next year, might be worth it to see now if the plans are truly the same, and see if the subsidy value is worth a possible difference in plan networks.
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Old 07-27-2015, 01:53 PM   #5
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Thanks for the replies.

I checked the doctors I/my kids have seen and their plan participation is the same whether I look through the MD state exchange,, or the insurer site directly.

So I decided to try going through the exchange now to hopefully make it easier for next year. After about 3 hours of fiddling, I decided it would not allow me to get different policies for myself and my kids, so I tried to enroll only myself. Supposedly I will be getting some enrollment package in the mail.

On it was easy to do one kid at a time and enroll each one in his own policy. So I did that, but got an email saying I have to upload proof of my qualifying event (i.e. termination of my current insurance). Of course, I don't have that yet, so I guess I will not be able to get this done until after my old insurance is no longer in effect and they send me some notice about it (naturally, the HR person is on vacation until 8/3).

Regardless, it looks like I will have no coverage for 2 weeks because my employer insurance stops 8/15 and the only choice for a starting date for the new policies was 9/1. I guess if something happens during that time, I can pay COBRA after the fact....
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Old 07-27-2015, 02:17 PM   #6
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I've just gone through this in CA ... and we decided to go off exchange w/ the ins co directly. It happens to be Kaiser and we already have Kaiser - so that was very easy in terms of the application.

As far as qualifying event, as best I can determine, you'd need to send them a copy of your COBRA notice from your (former) employer; that's required by law to be sent within 30 days of your last day of work (regardless of when coverage ends).

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