I retired before ACA, stayed on ACA from the inception until Medicare, wife is still on ACA.
Comparing employer, pre-ACA individual and ACA policies - at no time did our coverage generate any fear of medical bankruptcy or more uncertainty than earlier in life. Ironically, my employer coverage (major corporation) was mediocre and expensive, individual coverage (pre-ACA) here was mediocre in a different way, and ACA coverage choices varied from poor to excellent depending on making good selections. For us it was/is excellent from the start, and cheaper (net premium, plus out of pocket).
My judgement on all this was highly dependent on where we live and specific policy choices available. It was also made more palatable under ACA by my ability to manage income for some cost-sharing reductions and premium tax credits. We could have selected horrid insurance policies (in terms of having lousy networks), or great policies, here. And I've noticed lots of newbie insurers here that come and go on our exchange - a potential pain point if you mind switching physicians. In all our time on ACA, we never had an issue of acceptance, and never had a problem getting referrals when needed.
We started with PPO coverage under ACA and then shifted to HMO as fewer PPO choices were offered on the exchange, and PPO rates here increased beyond our tolerance. Stayed with same insurer from the beginning and noted little difference from this switch. That insurer is the largest in our state and in general is accepted everywhere. However, that insurer offers at least 3 different networks in my county. One really stinks - it is a very limited network and none of our past/present doctors participate. But the other two, priced a bit higher have presented no issues at all. Ever. There are areas in the country with few good choices and areas with lots of good choices. But you can completely assess this before signing up and steer to what works for your family. So shopping is critical, but somebody facing this decision in our county would not need to fear coverage difficulties.
Comparing employer, pre-ACA individual and ACA policies - at no time did our coverage generate any fear of medical bankruptcy or more uncertainty than earlier in life. Ironically, my employer coverage (major corporation) was mediocre and expensive, individual coverage (pre-ACA) here was mediocre in a different way, and ACA coverage choices varied from poor to excellent depending on making good selections. For us it was/is excellent from the start, and cheaper (net premium, plus out of pocket).
My judgement on all this was highly dependent on where we live and specific policy choices available. It was also made more palatable under ACA by my ability to manage income for some cost-sharing reductions and premium tax credits. We could have selected horrid insurance policies (in terms of having lousy networks), or great policies, here. And I've noticed lots of newbie insurers here that come and go on our exchange - a potential pain point if you mind switching physicians. In all our time on ACA, we never had an issue of acceptance, and never had a problem getting referrals when needed.
We started with PPO coverage under ACA and then shifted to HMO as fewer PPO choices were offered on the exchange, and PPO rates here increased beyond our tolerance. Stayed with same insurer from the beginning and noted little difference from this switch. That insurer is the largest in our state and in general is accepted everywhere. However, that insurer offers at least 3 different networks in my county. One really stinks - it is a very limited network and none of our past/present doctors participate. But the other two, priced a bit higher have presented no issues at all. Ever. There are areas in the country with few good choices and areas with lots of good choices. But you can completely assess this before signing up and steer to what works for your family. So shopping is critical, but somebody facing this decision in our county would not need to fear coverage difficulties.
Statistics: Posted by DetroitRick — Sat Mar 02, 2024 5:32 pm — Replies 28 — Views 1812