Should I buy COBRA PPO or an ACA marketplace EPO plan?

Obviously, the PPO is the better option, but the main issue is the price. The EPO (through BCBS) is around $350/month, while the COBRA option is around $650/month, which is extremely expensive.

The ACA plan is limited quite a lot due to being an EPO, though. For example, only certain hospitals are in network with this plan, and out-of-network hospitals are not covered at all, with the exception of the emergency room. This means that if I am admitted to the emergency room of an out-of-network hospital and then later admitted to the floor of this same hospital, the visit would not be covered. The only exception to this rule would be if the insurance company determines that your situation was enough of an emergency that you were unable to be stabilized and transferred to an in-network hospital. Trying to argue with the insurance company about what is and what is not an emergency sounds like a major headache, especially if you were simply brought to the closest possible ER/hospital out of dire need.

Not only that, but I have heard that it is possible for an out-of-network doctor or surgeon to be working at an in-network hospital. To me, there isn’t an easy way to prevent an out-of-network healthcare charge from occurring in this situation. The only way to prevent this that I can see is to call your insurance EVERY SINGLE TIME a new doctor at the hospital needs to order labs, run a test, or prescribe anything. Given that there are usually multiple different doctors doing rounds on the same patient each day at larger hospitals, this just does not seem like a feasible solution.

Also, the ACA plan does not cover any facilities out of state (to my knowledge) so the coverage would be limited if I wanted to travel as well.

If I have the money for it, is it worth the extra $300/month for the COBRA PPO plan? I don’t have any chronic health issues, and I don’t expect to be hospitalized for any reason, but with crazy people on the roads, shit can happen at any time. I am mainly wanting the insurance plan for therapy, and a few mental health drugs (which for the sky high cost of these premiums, it would be cheaper to pay out of pocket).

The health insurance is more so an ‘avoid crippling debt insurance’ seeing as it isn’t helpful in paying for what I need since the deductible is so high I will likely never hit it. But if the main reason I am buying the insurance – to avoid enormous debt if I am hospitalized – isn’t even valid due to the insurance not paying due to the hospital or doctor being ‘out of network,’ why buy the insurance at all? Why pay the hundreds per month if it pays for nothing? Healthcare in America is such a scam.

Is the ACA plan worth it or has anyone had good or bad experiences with it? Will it actually pay for what you need if you have a true emergency?Should I just buy the COBRA instead?

Or should I just say fuck it and move to Europe???