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Pentad78Prism

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  1. I am a 215 licensed agent in Florida. Currently I am appointed with National General and United Health Care. I help people with health insurance over the phone. I often get into conversations about whether someone should go to Obamacare or get a plan that I offer. I tell them that an Obamacare plan has pros and cons. Like Medicare supplements, any insurance company can offer an ACA plan as long as it is in compliance with ACA standards. That's where the 10 essentials come in, and the major upside of going with Obamacare. From wikipedia; The 2010 Affordable Care Act (ACA) set forth the following ten categories of essential health benefits,[2][3][4] at Section 1302(b)(1) of the ACA, codified at 42 U.S.C. ยง 18022(b):[5] Ambulatory patient services. [outpatient care] Emergency services. Hospitalization. [inpatient care] Maternity and newborn care Mental health and substance use disorder services, including behavioral health treatment. Prescription drugs. Rehabilitative and habilitative services and devices. Laboratory services Preventive and wellness services and chronic disease management; Pediatric services, including oral and vision care. This makes an ACA plan look great right? However, those plans have very limited networks, often super high deductibles, and high premiums if you do not qualify for an income based reduction. Aside from that, why else would someone choose a private company like NatGen with a short term 3 month plan or a indemnity plan? Usually because they do not need all the 10 essentials, and they can save money getting a policy more suited to the individual (or family). For example, if you are a 40 year old married couple with no history of drug or alcohol abuse and no mental health problems, why would you need mental health covered by your insurance? If you are a single man who wants health insurance, why would you want to pay extra for maternity care? With private insurance, a healthy individual can save money on premiums, and still have the peace of mind that good insurance brings.
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