General Category > General Questions
Insurance Outside the Healthcare Exchanges?
RichardP:
--- Quote from: PMRNC on October 02, 2013, 09:42:58 PM ---
--- Quote --- 4b. Any carrier offering insurance plans through the Healthcare Exchanges may still offer other non-exchange plans to the public, subject to state regulations (only?).
--- End quote ---
No, I don't believe so but I'm not 100% positive, I beleive they agree with the exchanges to operate within a special area of exchanges, however companies such as Aetna, for example, won't lose any market because of their multi=state operations.
--- End quote ---
My Point 4b was meant to be a statement, not a question. The only part that was a question is whether the non-exchange plans would be subject to more than just state regulations. You answered that question by reminding us that the ACA puts a floor under what may be offered outside of the exchanges, for all states.
The quote I gave from the Summary, as well as the paragraphs from the bottom of Page 30 and the top of Page 31 of the link in my first post make it clear that insurance carriers may offer plans both inside of the Exchanges and outside of them.
To repeat parts of the quotes in my first post:
... nothing in the law prohibits qualified individuals, qualified employers, and insurance carriers from participating in the health insurance market outside of exchanges.
An issuer may offer QHPs outside of exchanges as well as inside, but the premiums would have to be the same, even if the QHP is sold through an insurance agent.
That seems pretty clear that any carrier can offer plans through the Exchange, and other plans outside the Exchange - as well as offering the same plans for the same price both inside and outside the Exchange. But stay tuned ... perhaps that is an incorrect interpretation. I'm sure we will soon find out.
rdmoore2003:
I thought this was to be affordable....For just myself, a minimum monthly premium of $500 with $5000 deductible & $7500 oop. How is this affordable?
PMRNC:
--- Quote ---To repeat parts of the quotes in my first post:
... nothing in the law prohibits qualified individuals, qualified employers, and insurance carriers from participating in the health insurance market outside of exchanges.
An issuer may offer QHPs outside of exchanges as well as inside, but the premiums would have to be the same, even if the QHP is sold through an insurance agent.
That seems pretty clear that any carrier can offer plans through the Exchange, and other plans outside the Exchange - as well as offering the same plans for the same price both inside and outside the Exchange. But stay tuned ... perhaps that is an incorrect interpretation. I'm sure we will soon find out.
--- End quote ---
Sorry I didn't answer this sooner and I meant to revise that part of my post. YOU can go OUTSIDE the exchange on the private market, however, to get the tax credits you can only do that (if qualified income wise) through the exchange plans. TO Get those credits if qualified you have to go through a plan ON the exchange through the carriers that participate with that exchange. Unless I am misunderstanding your question. For example, if you live in a state where Aetna is not participating in the exchange, you can still buy insurance through Aetna but you will not receive the credits. If you go through a carrier that is not offering underwriting of plans in that state then you won't get the credits but they still have to meet the ACA minimum standards. A question to ask if I'm understanding you properly is : Why wouldn't you want to purchase on the exchange in that situation your cost is going to be lower (after tax credits). IF you don't qualify for tax credits than basically it's your choice.. you can still shop premium rates and you might find it cheaper on the exchanges.
--- Quote ---I thought this was to be affordable....For just myself, a minimum monthly premium of $500 with $5000 deductible & $7500 oop. How is this affordable?
--- End quote ---
LOL do you really want to get me started on this?? It is along the same lines as to why I refuse to call this "obamacare" and when someone asks me (anyone) how Obamacare is going to effect them I say "It won't because there is no such thing as Obamacare". You really don't want to get me started on this topic. LOL
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