Affordable Healthcare Act

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October 1, 2013 Americans can sign up for Medical insurance coverage through the government. There have been a lot of misinformation and people will have to decide who they believe. From the perspective of personal finance, this will be a very big choice for many people. From my reading I will provide the basics and not argue it.

Each state will have 100 medical policies which people can choose from. These are from the same companies and the same policies we have seen in the past. They are also at the same cost as in the past. The difference is if your family income is less then 400% of the federal poverty level, the government will pay a part of your monthly income. A family of 4 making $92,000 a year is under 400% of the poverty level. A family of 2 making under $40,000 a year is under 400% of the poverty level. So how much you will pay depends on last years adjusted gross income on your federal return and the government pays the rest. Some people do not want the government helping them pay so there is an option of paying the full cost each month yourself. A decent family policy runs between $1000 and $1400 monthly and you make the pick. A family of 2 making $40,000 a year is at $250% of the poverty level and will pay about $200 monthly and the government will pay $1200 monthly for this couple. One other thing to consider if you currently have a high deductible health plan and also pay premiums. If your deductibles, co-pays, and premiums cost you more then 9.5% of your income each year, you can apply under the affordable care plan to keep your health expenses below 9.5% of total health costs. Here is a calculator you can use to see what % of the poverty level your family is at, how much your will pay and how much the government will pay. Remember, use adjusted gross income.
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Well I am sure we can go on and on of what could have been, what should have been. In three weeks the law which passed 3... (more)

syber (Sep. 08, 2013 @ 1:54p) |

Umm, its spelled Kaiser, just like Kaiser Permanente (hint) - I know they say they are unbiased but come on

winter (Sep. 08, 2013 @ 5:32p) |

Unlike plans that we have purchased in the past, no individual exchange plans in NY provide out-of-network coverage. Mak... (more)

ryeny3 (Nov. 13, 2013 @ 9:00p) |

Something called Obamacare was apparently enacted. OP to provide commentary and impartial analysis.
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This post is riddled with inaccuracies:
100 medical policies for each state? Please cite source. I believe some states (Maine, Vermont) have only 1 or 2 companies offering policies.
How much you pay depends on current year Modified AGI, you can estimate it based on last years MAGI but you will have to pay it back if you make too much in the current year.
If your employer offers health care you are not eligible for the exchanges, regardless of income.

Please stop shilling for Obamacare and provide useful information.
There is lots of real information available on the early retirement forum in the sub forum Health and Early Retirement.
My bottom-line take is that if you have a job with health care now you will be worse off under O-care, if you have no job or no current health care you will be better off.
 

If people want to argue what is available I have no problem deleting the post. I have read about it looking to buy in myself. This is about health insurance finance passed by congress. If you feel what I posted is inaccurate post what you want. Like I said, One has to decide who they want to believe. There are people both working and retired who will be benefit and if this shoe doesn't fit you, then don't waste your time. . You can buy health insurance where ever you want and listen to whom you want. I am no shill for anyone. Politics is a different discipline then healthcare insurance. The best thing people can do is help others to understand. MAGI and adjusted gross income are different but most people will simply use the adjusted gross income because magi doesn't apply to most people. I could throw in a lot of complicaed stuff and make this sound hard, but the bottom line is about 100 policies to choose from, same policies we have had in the past from the same companies and at the same cost. Difference is most people will receive a subsidy and how much depends on how much your adjusted gross income or in some cases, MAGi is.
Currently I have a high deductible health plan which has a $2500 deductible per person before insurance pays anything. There are two of use so before insurance pays a dime, I have to spend $5000. At 250% of the poverty level, I can buy a better policy for my wife and I for $250 a month. $250 monthly times 12 equals $3000 yearly. That is a savings of $2000 yearly and I will have a better policy. I prefer to pay less for more then more for less. We all make our own choices.
If someone can point me elsewhere to a BCBS comprehensive medical policy worth $1400 monthly for 2 for $250 monthly let me know.

Wait, what!? When did this happen?

Can you provide more information from your analysis of how much this will cost me?

Insert your numbers in the calculator I provided. That should get you close.
 

syber said:   If people want to argue what is available I have no problem deleting the post. I have read about it looking to buy in myself. This is about health insurance finance passed by congress. If you feel what I posted is inaccurate post what you want. Like I said, One has to decide who they want to believe. There are people both working and retired who will be benefit and if this shoe doesn't fit you, then don't waste your time. . You can buy health insurance where ever you want and listen to whom you want. I am no shill for anyone. Politics is a different discipline then healthcare insurance. The best thing people can do is help others to understand. MAGI and adjusted gross income are different but most people will simply use the adjusted gross income because magi doesn't apply to most people. I could throw in a lot of complicaed stuff and make this sound hard, but the bottom line is about 100 policies to choose from, same policies we have had in the past from the same companies and at the same cost. Difference is most people will receive a subsidy and how much depends on how much your adjusted gross income or in some cases, MAGi is.
Currently I have a high deductible health plan which has a $2500 deductible per person before insurance pays anything. There are two of use so before insurance pays a dime, I have to spend $5000. At 250% of the poverty level, I can buy a better policy for my wife and I for $250 a month. $250 monthly times 12 equals $3000 yearly. That is a savings of $2000 yearly and I will have a better policy. I prefer to pay less for more then more for less. We all make our own choices.
If someone can point me elsewhere to a BCBS comprehensive medical policy worth $1400 monthly for 2 for $250 monthly let me know.

  

Most people won't qualify for a subsidy even if their income is within the thresholds you outlines?  Why?  Because if you or your spouse are eligible for a policy through work, you don't get a subsidy.  If you don't buy a policy, you get penalized.  If you work for a company that doesn't offer insurance and work more than 30 hours per week, the bill provides incentives for your hours to get cut to 30 hours or less reducing your income.   Those are facts.   Also, the plans that are available are now required to provide coverage for many expensive procedures thru various mandates and taxes.   Many on fatwallet who get employer coverage have already seen taxes go up to to negative changes and limits to flexible spending plans.

I get my health insurance from the employer I retired from. Because my yearly medical expenses exceed 9.5% of my income, I "am" free to go to the exchange.

This is the same for any employee actively working. If your yearly medical expenses to include copays, deductibles, and premiums exceed 9.5% of your  adjusted gross income, you can buy through the exchange and if less then 400% of the poverty level, will get the subsidy. The whole idea was to keep people from having to spend more then 9.5% on medical insurance and care. So you are correct that "if" your employer provides good insurance, then you will not qualify. But there are many people working who have high deductible plans, pay premiums, copays and deductibles like I do and will exceed 9.5% of their income.

If you work for a company 20 hours or 40 hours and the plan they offer does not meet the federal standard of a "qualified health plan", you can buy on he exchange. What ever your wage, if you make under 400% of the poverty level and your employer's health plan is not a qualified plan, you can buy ion the exchange. Like I said in the beginning, theere is a lot of misinformation out there and people have to make a choice what they wish to believe. I have been reading on the federal web sites and the kaiser web site now for months because I plan on leaving my employers plan because they do not meet the standard of the qualified health plan. Doing so will save me a lot of money and provide a better health plan for us.

I currently have a HSA and my employer contributes nothing. FSA's as well have got to be looked at closely to see if they are a qualified health plan. If not you will save money buying into the exchange or if you want, you can stay where you are at. 9.5% of your income is the line no one should cross. .

Questionss to ask yourself:
Is my employers plan a "qualified health plan?"
Is my family adjusted gross income under 400% of the poverty level measured on the calculator above?
Do I spend more then 9.5% of my income on premiums, copay's and deductibles?

If any of these three apply, one needs to look to find accurate information.

Interesting. It looks like the IRS will be using W2 Gross Income? So far this year I paid 9.52% of my income to my family's medical premium alone. I am currently dumping 22% of my income into my 401K. Without doing that, my plan would be affordable, but since I put so much in my 401K my medical plan is "unaffordable". Perhaps, I need to increase my 401K contribution some more if this would qualify me for a subsidy.

I don't understand why OP is getting red.  He is trying to help (however, I do see that his writing style can improve).

tolamapS said:   I don't understand why OP is getting red.  He is trying to help (however, I do see that his writing style can improve).
Maybe, because of complaining about misinformation.

There have been a lot of misinformation and people will have to decide who they believe.

Then made widely inaccurate statements. Each of these sentences are blatantly false.

Each state will have 100 medical policies which people can choose from. These are from the same companies and the same policies we have seen in the past. They are also at the same cost as in the past.

I recently switched my Insurance plan and bought through the MA Health Exchange, Plan is close to $20k a year but will get back about $13k in subsidies so i'm pretty happy. Not working really pays off. Also I read that they don''t think many, less than 30%, will know about using subsides the first couple years. I'm sure close to 100% of FW'ers will though. Have to love a country where I can spend almost $200k on a car and then get the Government to pay a big chunk of my insurance.

Not working pays off. RS4rings is correct. MS is far ahead of the game but other states are now catching up. The subsidies are big and will save many people money, at least for those under 400% of the poverty level with means under 92,000 year for family of 4. The thread was started to discuss what people will do to enter the affordable care act through the exchanges not to debate the act itself. There are many people out there who will benefit financially by entering the exchange beginning opening in one month. This thread discusses who might want to enter the exchange, why they would want to enter the exchange, income thresholds to enter the exchange, what is a qualified health plan with your employer, what is 9.5% of your adjusted gross income.

Debate ended and the new law begins in one month. Time to help the people who can save a lot of money by going on the exchange. The calculator above is the first place to start.

While the debate is over, the FatWallet effect hasn't begun. Clearly, OP shows the key threshold is if your plan costs 9.5% or more, plus if your income is < 4x the poverty level. Heavy contributions to a traditional 401K can be leveraged ($17,500 to $22,500 per year) to move MAGI into the right range compared to your premium. It can be stacked along with the Savers Credit. As there is no pre-existing condition clause you might be able to swap plans about creatively, get a better plan at times you have planned procedures and swap it about for cheaper or none at other times. As this is Fatwallet, let's talk about what we can do to leverage it. This may end up like the dollar-coin deal where it took a long, long time for it to go away.

The question I have is this, many red states resisted and failed to create state exchanges, will federal government provide exchange for these states or what?

lonestarguy said:   While the debate is over, the FatWallet effect hasn't begun. Clearly, OP shows the key threshold is if your plan costs 9.5% or more, plus if your income is < 4x the poverty level. Heavy contributions to a traditional 401K can be leveraged ($17,500 to $22,500 per year) to move MAGI into the right range compared to your premium. It can be stacked along with the Savers Credit. As there is no pre-existing condition clause you might be able to swap plans about creatively, get a better plan at times you have planned procedures and swap it about for cheaper or none at other times. As this is Fatwallet, let's talk about what we can do to leverage it. This may end up like the dollar-coin deal where it took a long, long time for it to go away.
 

I would imagine the vast majority of FWF posters have employer sponsored health insurance(which is likely a better subsidy than the exchange) that isn't going away with the ACA as they are high earners.

The majority of the rest are likely self-employed people who are making significant bank such that they are >4x poverty for their family size even with MAGI manipulation. So while some people on the forum may benefit from the exchanges and AGI manipulation(a topic I am very familiar with already due to IBR) I doubt it will be a significant portion.

FrugalFreak said:   The question I have is this, many red states resisted and failed to create state exchanges, will federal government provide exchange for these states or what?
  Yes. 34 States will not set up exchanges, people in those states will go to the federal exchange.

FrugalFreak said:   The question I have is this, many red states resisted and failed to create state exchanges, will federal government provide exchange for these states or what?
  Yes, if your state doesn't create an exchange, you will use the federal exchange.

RS4Rings said:   Have to love a country where I can spend almost $200k on a car and then get the Government to pay a big chunk of my insurance.
  
A sad comment about our country.  I don't blame you for taking advantage of it RS4, I blame the politicians/bureaucrats for being so incredibly stupid.

Leveraging the MAGI is an idea I had not thought of but your right, great idea. I know I took care to write down my agi as far as I could to be ready. About the majority of FW getting employer insurance that is considered a "qualified health insurance plan under the ACA. In my reading I found that many employers last year dropped coverage to high deductible plans and some of those plans will not qualify under the ACA. The reality is many employers do not want to pay for employees health insurance any longer and they look at the ACA as a way to no longer have to pay insurance. I have a municipal employer and there is no doubt they do not want to buy health insurance for their employees any longer. So if they can shove them off the policy onto the ACA, the family ends up paying $250-300 monthly for a $1400 policy with the subsidy covering the rest and they are not a high deductible health plan. The ACA also has HDHP's available for even lower cost and also catastrophic policies if a person is young and wants those which are really inexpensive.

The higher earners above $92,000 agi family of 4 will not benefit at all from the ACA but like you said, they have employer insurance.

syber said:   
Each state will have 100 medical policies which people can choose from.

  
THis is incorrect.  Each state will have its own setup (or use the fed exchange) and the # of plans will vary.   OR and WA have each announced ~50-60 plans.  
 

You are correct, those two states have 50-60 plans to choose from. I have seen them posted on the net. The number of plans are not fixed. Very important to know if your state has 60 or 100 plans available to choose from. But then again not all insurance companies like having their profits taken from them so they are not participating in all states. I suspect though, out of necessity, those companies will join in at some point because there goal is to make money, and the price for a family policy is not all that much different then today. What is different is more there are more protection in these exchange plans.  What is nice is people have the choice of having less protections and paying higher prices if they want and can keep what they have today. Paying higher premiums, copays and deductibles in today's plans give you more to write off if you can write down more then 10%. .

Nothing says "happy labor day" like a discussion of how to work less and manage your income down to get subsidized health care

maddybeagle said:   Nothing says "happy labor day" like a discussion of how to work less and manage your income down to get subsidized health care
  Subsidized hell! I want free health care like every other industrialized country. . Health care should be aright not just for the 1 %ers.

bopc1996 said:   
maddybeagle said:   Nothing says "happy labor day" like a discussion of how to work less and manage your income down to get subsidized health care
  Subsidized hell! I want free health care like every other industrialized country. . Health care should be aright not just for the 1 %ers.

  people in those other countries also pay close to 50% taxes.  While those that don't work pays little, if any.

bopc1996 said:   
maddybeagle said:   Nothing says "happy labor day" like a discussion of how to work less and manage your income down to get subsidized health care
  Subsidized hell! I want free health care like every other industrialized country. . Health care should be aright not just for the 1 %ers.

  
There is no free health care.
Somebody need to pay for it.

cr3s said:   
bopc1996 said:   
maddybeagle said:   Nothing says "happy labor day" like a discussion of how to work less and manage your income down to get subsidized health care
  Subsidized hell! I want free health care like every other industrialized country. . Health care should be aright not just for the 1 %ers.

  people in those other countries also pay close to 50% taxes.  While those that don't work pays little, if any.

  Whilst true for some countries, Australia, UK, Germany all have progressive tax rates of 0 to 45%, pretty close to the US range of 0 to 39% + state and local tax. Source

tmonkey said:     Whilst true for some countries, Australia, UK, Germany all have progressive tax rates of 0 to 45%, pretty close to the US range of 0 to 39% + state and local tax. Source
 

  ...And VAT...

IMBoring25 said:   
tmonkey said:     Whilst true for some countries, Australia, UK, Germany all have progressive tax rates of 0 to 45%, pretty close to the US range of 0 to 39% + state and local tax. Source 
  ...And VAT...

  And we have sales tax and state income taxes.
 

tolamapS said:   I don't understand why OP is getting red.  He is trying to help (however, I do see that his writing style can improve).
  Because more people here are interested in which credit cards will write off balances of less than a dollar?  

Seems we are still talking politics of a law which has been in effect for some 3 years now. People of Sweden, the best healthcare system in the world,  pay 50% of there wages in taxes. In the US we pay 25% in taxes( SS, state, fed tax)  right? Now add another 25% to that which your employer has paid for your health insurance and we are also at 50%.  15 industrialized countries around the world have government subsidized healthcare paid through taxes. We were behind the times. But at this point it is really a waste of time to debate something which has come to pass. People need to know will they have access to the exchanges, is there healthplan a "qualified healthplan" and the use of the calculator at the very beginning to see where they fall under the 400% poverty level. Also there are four levels of insurance which can be purchased on the exchange. Bronze, which pays 60%, Silver which pays 70%, gold which pays 80%, and platinum which pays 90% of all claims. You choose what you want. If under age 30, you can drop lower then the metals and get a catastrophic policy. The calculator at the beginning of this thread is based on the silver level policy. The gold and platinum will cost between 50-200 a month more when receiving the subsidy from what I can see over the sliver plan. Looking at the 4 states which have put there policies out on the net to see there some of them have dental and eye glass which for me is a plus.

tmonkey said:   
cr3s said:   
bopc1996 said:   
maddybeagle said:   Nothing says "happy labor day" like a discussion of how to work less and manage your income down to get subsidized health care
  Subsidized hell! I want free health care like every other industrialized country. . Health care should be aright not just for the 1 %ers.

  people in those other countries also pay close to 50% taxes.  While those that don't work pays little, if any.

  Whilst true for some countries, Australia, UK, Germany all have progressive tax rates of 0 to 45%, pretty close to the US range of 0 to 39% + state and local tax. Source

Not to mention that in 1986 our top tax rate was 50% on the nose (and there was a 70% top earner bracket in 1980. Go back to '63 and there was a 91% bracket).Source      

Argue about what we should pay all you want, but we are currently paying relatively historically low rates. 

So long as we are speaking about tax brackets, here is the calculator again so people can find out where they fall under 400% of the poverty level and how much subsidy they will receive. Remember to use adjusted gross income and for some who know what it is, MAGI.
MAGI = MAGI when it may apply.


400% calculator  



Currently, I am coming up with 7.8% of my income on the calculator will be used to pay for premiums as compared to what I now pay at 15% of my income. Anyone else find what they currently pay for premiums, copays and deductibles will go down with the exchange?

jerosen said:   
IMBoring25 said:   
tmonkey said:     Whilst true for some countries, Australia, UK, Germany all have progressive tax rates of 0 to 45%, pretty close to the US range of 0 to 39% + state and local tax. Source   
  ...And VAT...

  And we have sales tax and state income taxes.

I have neither, and certainly don't pay a 20+% VAT.

I'm in Washington and have been watching this closely. I've been paying $125/mo for a $10,000 deductible plan which basically doesn't pay for anything except 3 doctors visits per year until I hit 10K.  I've been buying on the individual market for ten years because I have no employer coverage.

We don't have anywhere near 100 plan choices through our state exchange. We have 4 companies, each providing a Catastrophic, Bronze, Silver, and Gold plan. One company is offering two different deductibles at each level. Additionally, 2 of the four companies offering plans are technically the same company and offer exactly the same plan choices and pricing. So technically, I will have 12 choices (no catastrophic choice for me at 35yo). This would be similar for any specific  individual in the state.   I suppose if you count each offering company and all the plans they offer in each region (I think there are 5 regions), you get about 100 total in the whole state. But an individual can only purchase plans available in their region/county. Big counties have more choices, rural counties have fewer choices. So saying we have 100 choices in our total state exchange is technically true, but very misleading on an individual choice basis. 

The big thing missing from our state exchange right now is the capability to see exactly what the insurance plans will cover, and at what levels.   The Bronze plan here will run $200-225 per month (at age 35 years), but what will that cover?  I believe the max out of pocket under the AHCA is $6350 and max coinsurance is 30%, but what do the plans look like beyond that?  You can currently buy plans on the open market in that price range, with 3-6 doctors visits per year, no drug coverage, $2500-$3500 deductible, and 25-40% co-insurance.  I'll be very curious to see exactly what the new plans cover, particularly drug benefits, lab/diagnostic benefits, and if there are office visit limits.  I'm certainly willing to buy if I end up with a useful product - paying $500 for a mammogram and ultrasound a few years ago was no fun when I had a lump in my breast and the procedures didn't qualify as preventative . 

I suppose the good news is that I don't really see an obvious price increase here our state (at my specific pricing for my age), and their MAY be a potential upside once we see the coverage docs.  Price differentials are going to vary widely by state and individual, no question. 

Maybe this will help you look at the Washington exchange a little closer. At the following site click on Washington, then look to the right and where you see released individual rates click on yes.
Cut and paste this URL:   https://www.statereforum.org/exchange-rates
 


There are still many plans pending state approval. Washington is one of the more progressive in this and is setting up there own exchanges. People reading this thread can look at this link to get an idea what is being offered, at least in Washington.

Also the plan you buy will be subsidized if you are less then 400% of the poverty level. So when you compare in exchange and out of exchange rates there is a huge difference in what you will pay because of the subsidy you receive in the exchange.

Regarding the high deductibles there is the 9.5% rule. If you like paying the high deductibles great. But for the same price you do not have to buy the high deductible plan. Remember one thing, On the bronze plan which pays 70% and you pay 30%. Your 30% will be on the discounted rate charged the insurance. Personally, I do not like 30% and would select a plan which pays 80% or 90% for just a little more per month but that depends on how much you use healthcare. .  Like you say you have not yet been able to see what the exact coverage is and this requires proper selection of a plan which fits you. There are trained navigators who are out there who can sit down with you and help you choose. I know for myself, it is hard to distinguish between the different plans. I know I will use consumer reports to find a highly rated company to start with.

RS4Rings said:   ..... Have to love a country where I can spend almost $200k on a car and then get the Government to pay a big chunk of my insurance.
 

  most countries pay not "a big chunk", but cover the whole cost of it (look to the north for instance).

back to the subject: i buy insurance myself, I guess "on exchange" (Mass Connector in my case) and I do not see much improvements, though I am not qualified for any subsidy, of course.
to get to 10% expense is very extreme I think and it seems to me the Gov pays only when you get over that threshold.

syber said:   ...
 


There are still many plans pending state approval. Washington is one of the more progressive in this and is setting up there own exchanges. People reading this thread can look at this link to get an idea what is being offered, at least in Washington.
 There are trained navigators who are out there who can sit down with you and help you choose. I know for myself, it is hard to distinguish between the different plans. I know I will use consumer reports to find a highly rated company to start with.
 

  
the problem with all of this, - when you decide to buy health insurance you basically buy a future (CBOE term) and you never know by definition if it is a right choice today.

btuttle said:   
jerosen said:   
IMBoring25 said:   
tmonkey said:     Whilst true for some countries, Australia, UK, Germany all have progressive tax rates of 0 to 45%, pretty close to the US range of 0 to 39% + state and local tax. Source    
  ...And VAT...

  And we have sales tax and state income taxes.

I have neither, and certainly don't pay a 20+% VAT.

  
Which state doesn't have sales or income taxes?   Alaska?

 

borges said:   
RS4Rings said:   ..... Have to love a country where I can spend almost $200k on a car and then get the Government to pay a big chunk of my insurance.
  most countries pay not "a big chunk", but cover the whole cost of it (look to the north for instance).

back to the subject: i buy insurance myself, I guess "on exchange" (Mass Connector in my case) and I do not see much improvements, though I am not qualified for any subsidy, of course.
to get to 10% expense is very extreme I think and it seems to me the Gov pays only when you get over that threshold.

  

What do you mean the government only pays when you get over that threshold?

THe subsidies under the new law are based on income levels.   It has nothing to do with out of pocket costs.     There is a 9.5% threshold on whether or not you can itemize and deduct your health care out of pocket spending.   These aren't the same things.
 

Skipping 27 Messages...
syber said:   October 1, 2013 Americans can sign up for Medical insurance coverage through the government. There have been a lot of misinformation and people will have to decide who they believe. From the perspective of personal finance, this will be a very big choice for many people. From my reading I will provide the basics and not argue it.

Each state will have 100 medical policies which people can choose from. These are from the same companies and the same policies we have seen in the past. They are also at the same cost as in the past.
The difference is if your family income is less then 400% of the federal poverty level, the government will pay a part of your monthly income. A family of 4 making $92,000 a year is under 400% of the poverty level. A family of 2 making under $40,000 a year is under 400% of the poverty level. So how much you will pay depends on last years adjusted gross income on your federal return and the government pays the rest. Some people do not want the government helping them pay so there is an option of paying the full cost each month yourself. A decent family policy runs between $1000 and $1400 monthly and you make the pick. A family of 2 making $40,000 a year is at $250% of the poverty level and will pay about $200 monthly and the government will pay $1200 monthly for this couple. One other thing to consider if you currently have a high deductible health plan and also pay premiums. If your deductibles, co-pays, and premiums cost you more then 9.5% of your income each year, you can apply under the affordable care plan to keep your health expenses below 9.5% of total health costs. Here is a calculator you can use to see what % of the poverty level your family is at, how much your will pay and how much the government will pay. Remember, use adjusted gross income.
calculator      

Video- aca explained 

Unlike plans that we have purchased in the past, no individual exchange plans in NY provide out-of-network coverage. Making matters worse, we don't know if any of the doctors that we have used in the past will be part of any exchange plan's network. Do other states have broader networks? 



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