FL Blue Marketplace plan choices
This is my third go-round in this state figuring out ACA insurance, for some reason it continues to scramble my brain… Because of my healthcare needs/preferences (& the options available here), I’m sticking with Florida Blue EPO, and since I’m currently eligible for cost sharing etc, looking at Silver plans. Currently on Blue Select1456C, which I know I did a lot of mental gymnastics to decide on last year, but am not 100% sure it’s the right choice.
One of my issues is the narrowness of my network: I knew going in that Marketplace has narrow network, as does any EPO, but my (relatively new to me) area has a shortage of providers taking new patients on it’s own. Last year, I briefly considered going with a Blue Options plan vs Blue Select due to the broader network, but determined that unless I was going to a OON provider multiple times a month, it would not be worth the $350+/month increased premium vs Silver, and I’d be better off just going out of pocket if needed. Except the one time I was referred to a OON provider I wanted to see, they basically said nope, they wouldn’t take anyone OON. Which made zero sense to me– my plan covers OON, just at a ridiculous deductible, so they/I could still submit, knowing I’d need to cover 100%–but they were adamant. Fortunately, I managed to dig up one other dr in that specialty nearby who does take my insurance, but got me to thinking again…
Part of me is considering picking the plan with the lowest premium and just hoping other OON providers I might want to see in the future are more reasonable, expect to not always be able to use the insurance for appointments. Does this seem the best approach at this point (assuming current dr’s & rx’s covered)? (I have some low grade health stuff I’m digging into, so am sometimes interested in specific dr’s for a reason vs just anyone in the speciality, that’s why OON is on my mind.) Also, I’d considered looking for providers to consult out of state, but it sounds like I can’t anticipate ACA plans covering something like that– am I understanding that correctly? Finally, I’ve been ignoring Gold plans since it sounds like they make no sense if you’re eligible for CSRs, but I’m *hoping* to change my income enough next year to cross that limit–since that’s not guaranteed, though, just planning as if I’ll stay within the CSR zone and will deal with any downsides if/when they come. Hopefully that makes sense?
TIA for any input, I’m just finding too many numbers and hypotheticals to feel like I’m processing anything correctly anymore, and am getting burned out!
