Good PPO plan for pre-65 in FL?

[Scuba]

We will be moving in October and need to change our health insurance to a FL plan. Neither of us is on Medicare yet. We want a PPO plan that gives us lots of options. We will be living in the Sarasota area.

If anyone has suggestions about good insurance plans that are PPO’s, I’d appreciate it.

 

[PaunchyPirate]

Have you reviewed the healthcare.gov ACA exchange? That is where you should start. You can create your account and enter your location/ages/income/etc. and see all the plans available to you and if you will qualify for any financial assistance. Even if you make too much money for a financial subsidy, you can still purchase thru the exchange.

Florida may be one of the states where you can also purchase plans outside of the exchange. But I would still start there.

 

[Dtail]

Yes check out the Healthcare exchange site.
We use the Florida Blue plan, which is a PPO plan in state. Access to all doctors. Very good coverage at reasonable rates. Of course the rates are affected by your income (MAGI).

 

[FLSUnFIRE]

I'm very pre-65 and happy with FL Blue Select HSA eligible PPO (there is an options too but my preferred docs/providers are on the smaller network).


ETA mine is 1735 as well. Agree with Aerides on provider availability and premiums. I'm getting a subsidy but "budget" the full amount in my expenses and still think it's reasonable at full price. I'm as happy as I was with my FEHB plan -only real downside is the FEHB covered me anywhere but I'm not outside of FL that often and if/when I travel extensively, I'll buy a travel policy.

 

[Aerides]

Not all plans are in all counties I understand.

Ours is Florida Blue BlueSelect Bronze 1735 HSA.

It's a high deductible PPO, with very reasonable premiums after middle-range subsidies, and the best match for our providers.

 

[FlaGator]

Not all plans are in all counties I understand.

Ours is Florida Blue BlueSelect Bronze 1735 HSA.

It's a high deductible PPO, with very reasonable premiums after middle-range subsidies, and the best match for our providers.

^^^^^^
This is the plan I have used for several years.

 

[Scuba]

Thanks for the information. I spoke with an independent broker today. He was pushing “United Healthcare Choice Plus.” Said you have to qualify via medical underwriting to get this plan, but since I’m pretty healthy he felt I would qualify. Said it’s a PPO with maximum $3K out of pocket. It’s a “private” plan, not an exchange plan. We currently have a “grandfathered” plan, also not an ACA plan. The main advantage seems to be coverage when out of state.

I need to do more research but one thing I found concerning is that I’ve heard from several sources that Sarasota Memorial Hospital is the best hospital system in the area. He said they are forming their own “closed system” similar to Kaiser, whereby they aren’t going to take any non-ACA plans, either our current one or the proposed one he presented to me. Yet if we took a Sarasota Memorial plan, all other docs would be out of network.

If anyone lives in the Sarasota area and can confirm or deny this information, please DM me or comment here. I guess I will call the Sarasota Memorial billing office and try to find out if this is accurate. We’d like to have access to the best hospital system, but prefer to be able to freely access doctors as needed.

 

[Aerides]

The main advantage seems to be coverage when out of state.

One thing about out of state - Florida Blue does cover you quite well, it's a separate OOP/Deductible, but it's not nothing. It's far more than you hear about with some other providers. You'll want to look at all the fine print in all the plans of course.

 

[simple girl]

We will be moving in October and need to change our health insurance to a FL plan. Neither of us is on Medicare yet. We want a PPO plan that gives us lots of options. We will be living in the Sarasota area.

If anyone has suggestions about good insurance plans that are PPO’s, I’d appreciate it.

We use Florida Blue Options PPO/EPO. There are several Options Plans - we like to have an HSA so we go with the 1705 plan, even though it is a bit more expensive. It offers a very wide selection of providers, which is important to us, too.

We use a broker to select plans every year. I give him a list of all of our docs, and he lets me know which plans accept those doctors and provides quotes.

The Select Plans mentioned by others does not include all of our doctors that we want, so we opted for the more expensive Options plan. Those who live in Tampa seem to have more choices with Select compared to what is offered by it here in Sarasota.

Our broker has never suggested the UHC Plus plan you mentioned, so I'm unable to help with that.

I haven't heard anything about the SMH closed network developing but that doesn't mean it isn't true.

 

[teej1985]

Thanks for the information. I spoke with an independent broker today. He was pushing “United Healthcare Choice Plus.” Said you have to qualify via medical underwriting to get this plan, but since I’m pretty healthy he felt I would qualify. Said it’s a PPO with maximum $3K out of pocket. It’s a “private” plan, not an exchange plan. We currently have a “grandfathered” plan, also not an ACA plan. The main advantage seems to be coverage when out of state.

I need to do more research but one thing I found concerning is that I’ve heard from several sources that Sarasota Memorial Hospital is the best hospital system in the area. He said they are forming their own “closed system” similar to Kaiser, whereby they aren’t going to take any non-ACA plans, either our current one or the proposed one he presented to me. Yet if we took a Sarasota Memorial plan, all other docs would be out of network.

If anyone lives in the Sarasota area and can confirm or deny this information, please DM me or comment here. I guess I will call the Sarasota Memorial billing office and try to find out if this is accurate. We’d like to have access to the best hospital system, but prefer to be able to freely access doctors as needed.

I can't imagine it's in your interest to go to a plan that isn't ACA compliant.

 

[Scuba]

I can't imagine it's in your interest to go to a plan that isn't ACA compliant.

DH has been on a non-ACA plan since 2013, and I got onto it when I retired in 2016. One advantage seems to be portability - you can use it out of state and we travel quite a bit. When we spoke with our insurer about converting to an ACA plan, they said the “grandfathered” plan was much better, although I don’t recall all the details as to why. I do know that while our deductibles are very high, the network of providers we have access to has been great. No problem getting coverage for the cream of the crop doctors.

Our income doesn’t allow us to qualify for ACA subsidies. Given that, is there another reason you believe ACA plans are superior?