The obamacare plan I have has a very high out of pocket maximum and a very high deductible and a high premium. You can actually have any out of pocket maximum you want if you are willing to pay a ridiculous premium. I can, however, pretty much go anywhere I want as the network is extensive. One of the biggest flaws in the obamacare plans, IMHO, is the lack of means testing. If you understand the rules, it may be easy to get a big, fat subsidy, which is exactly what I do. I restructured our investments to minimize (until I am on Medicare) capital gains and dividends from our non-qualified investments to keep our MAGI low enough for a subsidy. I would really have been fine with a much lower cost non-obamacare compliant catastrophic plan but will pay less with the obamacare plan with subsidy. They don't look at your net worth when computing the subsidy. You can have a $25M net worth and still receive a subsidy.
I also earned the premium credits. $500 for about 20 minutes of effort.
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Originally Posted by OrangeBlossomBaby
I'm on FloridaBlue too, with subsidy (tax rebate) from the ACA. Other than the deductible ($3500 individual or $6000 couple, if I remember right?), it's fairly similar to what we had up north. We didn't have any deductible up there.
We have co-pays, which are higher than up north, but still affordable. We have to get pre-certified for pretty much everything here in Florida, and could see a specialist without "permission" in the north. Rx coverage was exactly the same as it was in the north, except that fewer pharmacies participate down here. I had to switch my prescription from mail-order to Walgreens, but the cost is the same for the prescriptions.
The upside to Florida Blue is - even though we are charged a very small monthly premium, they have activities you can participate in to earn credit toward those premiums. So we haven't actually had to PAY any premium since February, and we still have a couple hundred bucks in credit.
My doctor is good enough for my needs, which is mostly to make sure I'm healthy once a year, and renew my prescriptions twice a year.
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