EPO versus PPO

[ritaxis]

So I'm getting ready to sign up for affordable insurance.

The option that costs me a dollar a month after the subsidy is EPO: exclusive provider only, which means you have to choose from the list and you can't go off the list at all except for emergencies. The option that costs 77 dollars a month is Kaiser Permanente, which is an HMO (helath maintenance organization, with their own clinics and hospitals that you use)whose closest clinic is an hour's drive away over the hill. The option that costs me 79 dollars after the subsidy is a PPO (preferred provider organization), in which you pay more for providers off the list but they do cover something, but it is Anthem Blue Cross, which gives me the creeps because of past misbehavior. And then there's Health Net, which has the same coverage and is a PPO, but it costs 155 a month after the subsidy.

more research is clearly necessary.

Comments

[al-zorra.livejournal.com]

Obamacare managed to do a deal here in New York state that makes it all more expensive than ever!

Love, C.

[ritaxis.livejournal.com]

Are you sure about the final cost? Because the cost listed for Covered California is very high until you go through the calculator. At my age and projected income, which is pretty low, my most expensive "silver" option (the "bronze" options are more expensive and I don't get why they are offering them to me because the coverage and payments are the same across the board -- by state law or something?) goes from $800 something to $155, while the least expensive goes from $700 something to $1 (one dollar). If all I saw were the preliminary costs I would have to throw up my hands and say I'd have to break the law. Even with the rebates: because I can't pay that much upfront and get it back the next year. It's the subsidies that make the difference, and the subsidies are not published in a set of tables you can just glance at. You have to run the calculator to find out. But the calculators are free and open to use -- you don't have to be applying to use them -- and you can run them for any number of actual and hypothetical situations.

Not saying New York has it too, only that it could be like that also?

[al-zorra.livejournal.com]

Indeed, it is really complicated. Worse, they haven't rolled anything out until today -- and it's terribly incomplete yet too.

New Jersey is even higher than we are. They have far fewer providers to choose from than most do nationally, which is supposed to be part of our problem too. I have heard that California is better than most. They're certainly earlier than many.

I have no faith in this system because it is still through the insurance industry which is running the shebang. And they are the problem.

Love, C.