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 > Affordable Health Care Act

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TCI

Everywhere. USA

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Posted: 10/04/13 08:28am Link  |  Print  |  Notify Moderator

Morning all. We are fulltimers and rarely stay in one state more than 6 months in the winter and 1 month in the summer. We have our domicile at South Dakota. We do not qualify for medicare or medicade. Our current insurance which we pay, is set up that we can visit any doctor in any state. My concern is, if we register in SD, can we get care in say SC, FL, AZ, TX, etc. I was reading about the marketplaces and it didn't seem clear. It sortof read in emergency situations. So I thought I would put this out on the forum and see what your opinons are for fulltimers. Thanks for the info.


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eubank

bosque farms, nm

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Posted: 10/04/13 08:45am Link  |  Print  |  Notify Moderator

Living "out of area" is always a little tricky with insurance companies because they typically chop your benefits for living out of state -- as we found out to the tune of several hundred thousand when receiving treatment for serious illness while living out of state. Not sure about this, but I don't think the ACA did anything about this kind of situation; they were more concerned with pre-existing conditions and the like. (Speaking of which, I'm certainly happy with that pre-existing clause of the ACA. My wife and I would both be in deep doo-doo without it.)

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Posted: 10/04/13 08:58am Link  |  Print  |  Notify Moderator

Being as I believe you can choose your coverage, I'd make that a priority when looking for the one you will need.
The whole thing is pretty confusing, and probably more so for Full-Timers.

Good Luck


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sdianel -acct closed

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Posted: 10/04/13 09:15am Link  |  Print  |  Notify Moderator

So far the state exchanges don't seem to be cheaper than purchasing insurance on the open market. You might consider getting a quote from Blue Cross Blue Shield or any national insurance company that will cover out of state costs. As long as the plan you purchase meets the new ACA requirements. Then you can compare the plans offered on the state exchange. It's my understanding that you must purchase on your home state exchange as most can't sell across state lines. Plan to pay high rates and high deductibles. Saw one ACA example, male, pre-existing Diabetes, income $45-55K, premiums $597 per month with $13,998 in deductibles before the "insurance" paid one cent.

TechWriter

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Posted: 10/04/13 09:23am Link  |  Print  |  Notify Moderator

TCI wrote:

We have our domicile at South Dakota. We do not qualify for medicare or medicade. Our current insurance which we pay, is set up that we can visit any doctor in any state. My concern is, if we register in SD, can we get care in say SC, FL, AZ, TX, etc. I was reading about the marketplaces and it didn't seem clear.

You use your domicile state when signing up for a ACA plan.

"Where" you get care, like network or out-of-network, depends on the plan you sign up for. However, you could get emergency room treatment anywhere regardless of your plan.


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earlvillestu

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Posted: 10/04/13 09:55am Link  |  Print  |  Notify Moderator

Don't know where the previous poster is getting his information on an "ACA plan," but under the ACA the maximum allowable deductible is $6250 for an individual or $12,500 for a family. Lower deductible plans are available. The plan we just signed up for has a family deductible of $3000


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sdianel -acct closed

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Posted: 10/04/13 10:38am Link  |  Print  |  Notify Moderator

I got my info from a friend on Facebook who tried to sign up for the family plan. His out of pocket would be $13,000 plus $597 per month.

eubank

bosque farms, nm

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Posted: 10/04/13 10:40am Link  |  Print  |  Notify Moderator

The deductible on our plan refers to individual treatments. When cancer treatments are calculated, however, it's by the visit to the hospital. Many, many visits to the cancer center, daily for months. Suddenly, your stuck with a mountain of payments.
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Posted: 10/04/13 10:44am Link  |  Print  |  Notify Moderator

sdianel wrote:

I got my info from a friend on Facebook who tried to sign up for the family plan. His out of pocket would be $13,000 plus $597 per month.


I've seen something similar, also on FB.

It really depends on if you have a State Exchange or the State you're in has defaulted to the Federal Exchange. Some even have a combo of both. They aren't all the same.


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earlvillestu

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Posted: 10/04/13 11:47am Link  |  Print  |  Notify Moderator

"Total out of pocket" is not the same as "deductible." There is no ACA compliant plan that doesn't "pay a dime" until the policy holder has spent $13,000.

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