I really have to bite the bullet this week and sign up for insurance for 2016. As a resident of Texas (Travis County), I am caught in the vanishing BCBS PPO conundrum. Sigh.
I don't use much in the way of medical services. This year I had a BCBS HSA-Eligible bronze plan 006 with the deductible nearly at the OOP max for in network. It also had 0% coinsurance. I will have only spent about $1000 for medical services.
My biggest concern is protection if I have a significant medical event -- so essentially catastrophic insurance.
How does coinsurance work? I thought I understood, but ...
One broker has told me that if I select a plan with, say, 20% coinsurance after deductible, it is capped by the OOP max. In this case, coinsurance doesn't worry me; I have stop-loss protection. Another broker has said that the OOP max does not apply to coinsurance. It is this latter case that bodes financial ruin.
Someone must be wrong. So how does coinsurance work?
I'm looking on and off exchange for a policy that does not require PCP referrals to a specialist (I don't want a Bozo PCP saying "no, you cannot see your ophthalmologist for a potential detached retina.") .
My carefully-constructed income would qualify me for an on-exchange policy in 2016 unless I receive an inherited IRA with RMD -- which now seems likely. I am tempted to buy on-exchange nonetheless if there is an appropriate policy, and square up with the IRS at tax time.
Note that in Texas, your insurance card is marked with "QHP" if you buy a policy on-exchange. The Scarlet X, screaming "needs federal subsidy, may not pay bills."
And I'm looking to move to another state by 2017....
Thanks!
I don't use much in the way of medical services. This year I had a BCBS HSA-Eligible bronze plan 006 with the deductible nearly at the OOP max for in network. It also had 0% coinsurance. I will have only spent about $1000 for medical services.
My biggest concern is protection if I have a significant medical event -- so essentially catastrophic insurance.
How does coinsurance work? I thought I understood, but ...
One broker has told me that if I select a plan with, say, 20% coinsurance after deductible, it is capped by the OOP max. In this case, coinsurance doesn't worry me; I have stop-loss protection. Another broker has said that the OOP max does not apply to coinsurance. It is this latter case that bodes financial ruin.
Someone must be wrong. So how does coinsurance work?
I'm looking on and off exchange for a policy that does not require PCP referrals to a specialist (I don't want a Bozo PCP saying "no, you cannot see your ophthalmologist for a potential detached retina.") .
My carefully-constructed income would qualify me for an on-exchange policy in 2016 unless I receive an inherited IRA with RMD -- which now seems likely. I am tempted to buy on-exchange nonetheless if there is an appropriate policy, and square up with the IRS at tax time.
Note that in Texas, your insurance card is marked with "QHP" if you buy a policy on-exchange. The Scarlet X, screaming "needs federal subsidy, may not pay bills."
And I'm looking to move to another state by 2017....
Thanks!