[quote=no_such_reality]There aren’t a lot of Doctors either. If your eyes have swelled shut, I’d consider that a shock type scenario, that’s not a normal allergic reaction and I suspect doctors would agree. If your eyes have swelled shut, what else is going to swell shut.
Those expenses are just as expensive on a PPO non-preferred list. With coverage often around 50% and a typical doctor visit in the $150-$200 range.[/quote]
nsr, rates for a specialist in rural flyover America are closer to $75 per visit ($75-$90) or $50-75 for a PCP … that is, unless they have to make a house call … and some still DO. Again, you’re operating on your SoCal mindset … as would be expected :=0
[quote=no_such_reality]Are for prescription coverage, the Rx is the Rx, where it was prescribed shouldn’t matter.[/quote]
That’s true, as long as your PPO’s drug network is in all fifty states (check the fine print on those EPOs). My current carrier’s is, as is their physician network. You are correct in that a typical PPO’s coverage level is just 50% for an out-of-network provider or facility. But this is a whole lot better than a kick in the backside if one has no choice but to utilize out-of-network care.
[quote=no_such_reality]Good info about the plans being cheaper off the exchange in the other States. I hadn’t thought of that and in retrospect, it makes complete sense.
If you’re under 400% FPL, the plans on the exchange aren’t the plans, they’re enhanced plans and the enhanced silver quickly looks more like a Gold plan due to the lower co-pays etc.
Essentially, the plan Silver plan is based on an expected applicant pool that will really qualify for a “gold” plan service level on a “silver” plan, where as off list, the silver plan is the silver plan.[/quote]
Agree, but if given the choice, I would still try to pick a plan which the masses of longtime uninsured likely won’t pick, due to cost (over and above the tax credits) or deductibles or both (possibly shunning the “enhanced silver” plans?). Rate hikes can EASILY double a monthly premium in 18-24 months. At my age, that’s a LOT of $$.
