trirod
Recycles dryer sheets
- Joined
- Jun 21, 2007
- Messages
- 148
So my wife and I need to decide whether to continue with COBRA for 2020 or go with an ACA plan. It seems like the ACA plan should be much cheaper (with subsidies), but I'm nervous about any "gotchas" or other unknowns so I'm looking for the voice of experience on this forum.
Our situation is that my wife retired in June and is currently on her employer's COBRA (our income is too high in 2019 to qualify for subsidies so ACA was not a consideration for 2019). I semi-retired 12/31/18 but am still covered by my employer's insurance through the end of this year. Our main options for 2020 are for us to both go with COBRA, at a monthly premium cost of around $1,000 per month, but with pretty good (and known) coverage through Blue Cross Blue Shield. Or to go to the exchanges and (after expected subsidies) get a BCBS HMO bronze HSA plan for around $200 per month (but max out of pocket of $6,850 each). Or we could go with a PPO for around $435 per month.
We are both in generally good health (touch wood!) but it seems like even if we both hit the max out of pocket in 2020 (which I really hope is unlikely!) then it still will be cheaper to be on the exchange than on COBRA.
So some of my questions are:
- Will I notice a big difference moving from a PPO to an HMO? It seems my primary care doctor and hospital network here is in the BCBS HMO network. Just wondering if there could be issues with specialists not being covered? Anybody have personal experience of that?
- Is there any fundamental difference between BCBS plans on the exchange vs. the BCBS plan I currently have with my employer? I am assuming they should have the same networks, but maybe that is naive?
- Any other differences between COBRA and ACA coverage that I am not thinking of (other than premium costs?)
Thanks for any help with this very confusing issue (I've lived in the US for nearly 25 years but am originally from the UK where, whatever its other shortcomings, the health care system is way simpler to understand!).
Our situation is that my wife retired in June and is currently on her employer's COBRA (our income is too high in 2019 to qualify for subsidies so ACA was not a consideration for 2019). I semi-retired 12/31/18 but am still covered by my employer's insurance through the end of this year. Our main options for 2020 are for us to both go with COBRA, at a monthly premium cost of around $1,000 per month, but with pretty good (and known) coverage through Blue Cross Blue Shield. Or to go to the exchanges and (after expected subsidies) get a BCBS HMO bronze HSA plan for around $200 per month (but max out of pocket of $6,850 each). Or we could go with a PPO for around $435 per month.
We are both in generally good health (touch wood!) but it seems like even if we both hit the max out of pocket in 2020 (which I really hope is unlikely!) then it still will be cheaper to be on the exchange than on COBRA.
So some of my questions are:
- Will I notice a big difference moving from a PPO to an HMO? It seems my primary care doctor and hospital network here is in the BCBS HMO network. Just wondering if there could be issues with specialists not being covered? Anybody have personal experience of that?
- Is there any fundamental difference between BCBS plans on the exchange vs. the BCBS plan I currently have with my employer? I am assuming they should have the same networks, but maybe that is naive?
- Any other differences between COBRA and ACA coverage that I am not thinking of (other than premium costs?)
Thanks for any help with this very confusing issue (I've lived in the US for nearly 25 years but am originally from the UK where, whatever its other shortcomings, the health care system is way simpler to understand!).