[quote=citydweller]The carriers/plans info is available at Covered California.
Click on “Resources”, then click on “Calculating Potential Insurance Cost”, then click “Get Started”.
Next, enter info, # of people in household, income, zip code and age. At the bottom of that page click the yellow button “See my options”.
Next will open a pop-up window with general information, you need to close that pop-up window. Underneath you will see the Bronze/Silver plans available in your area.
Choose the plan you’re interested in and click the “view details” button, then scroll up and click on “view plan benefits”.
At the top of that page you can also click a button that will take you to the Gold/Platinum plans.
In San Diego it looks like the Silver Plans are Anthem Blue Cross EPO, and Health Net, Sharp or Kaiser HMO’s.[/quote]
Thanks, citydweller. I did this exercise and found out I’m eligible for one of the “Enhanced Silver 87” plans for “free” but I don’t want one because if I don’t use ALL of my monthly healthcare allowance, I will lose the balance. I’m probably going to sign up for a Platinum Plan for $34 – $57 mo out of pocket and get more bang for my buck and lower my deductible to nothing with a coinsurance (incl copays) of about $4000 (after tax credit and HC allowance). CoveredCA’s plan selection in SD County is sorry ass, IMHO. There is just one PPO with a marginal carrier. It appears that Blue Shield of CA will not be issuing plans in SD County. The masses down here seem to prefer HMOs so that is what they are getting. My feeling is that it has to do with our huge military presence using Tricare Standard/Prime and Tricare for Life PLUS the presence of one of the largest regional EPO’s in the country, Sharp Healthcare (who is offering several plans on the exchange). The masses here have long been trained to visit PCPs first, pull a number and wait their turn to recieve a referral to a “member” specialist.
If I were to sign up for Sharp Platinum HMO, I sadly only have one local doctor out of five I currently see who is on Sharp’s “Premier Provider Directory” and that is only because he has privileges at Sharp Memorial Hospital in SD. Even their “Premier” list (Platinum on the exchange) is 85-90% doctors who work directly for them.
The vast majority of the top physicians in town are independents (have their own practices). Most of them run clinical trials, are guest speakers in conferences, teach specialized procedures to medical students and are also well-known expert witnesses. Many of them own their own medical buildings in REITs or in direct partnership with other physicians and are also part-owners in standalone surgicenters and other buildings they regularly practice in. The majority of them are over the age of 65.
I don’t want to be misdiagnosed, prescribed the wrong drug, given the “runaround” or be operated on by a newbie or a cog working his/her “system” because they are not yet successful enough to pay their own malpractice premiums. SD County is very fortunate in that we HAVE many very experienced, competent and renowned doctors (and dentists) practicing here. For this reason, I don’t really want to drop them and change to lesser providers or a lesser system if I can possibly help it.
It’s all about CHOICE (which isn’t that good in Region 19 – SD) and I’m noticing that several NorCal ruralish regions on the exchange (which I’m considering “retiring” to) have Blue Shield and other PPOs to choose from (likely because they have little or no access to HMO/EPO providers). I would rather have that and be able to choose to have a planned diagnostic visit, treatment or surgery ~200 mi away in SF, UC Davis, etc by a highly experienced specialist of my choice.
I only have to worry about signing up for 2014 in SD right now and, of course, will have to take what is on offer. All h@ll could break loose for me between now and this time next year, when I have to sign up for 2015 so I guess I can do anything for one year :=0
Thanks again for the instructions, citydweller.
*****
Later edited to state that I qualify for “Enhanced Silver 73” plan, not 87 plan as previously stated. Upon further research, my drs all appear to take HealthNet so will further check out those offering(s) on the exchange.
Still later: Ahhhh …. I didn’t see the right arrow on the Platinum plans. I just found Blue Shield of CA Platinum PPO in SD at a $117 mo cost to me (after tax credits and HC Allowance). Perfect!
