Off Exchange carriers Appointment's what do I need to know?

[vic120]

I have only done ACA, But I am told off exchange is important too
I have have several ask about it, one told me they work in multiple states
I have also had several medical providers tell me personally marketplace plans don't cover as much and are not well liked

But I never hear about this from agents or FMOs what's the skinny?
what's good what do I need to know
what are the benefits of buying off exchange?
Does it cover out of state?
does it still cover pre ex?
who are the carriers ?

 

[Yagents]

I stopped writing off market years ago.

Had a few tell me they have high income and then lost their job or income and expected an aptc refund. Ummm.....sorry you won't get the $10,000 aptc refund since we didnt buy on market since you told me $300k of expected income and didn't want to enroll thru thru the govt.

The same carriers and appointments that have on marketplace plans have off market plans.
There are no hidden carriers. All have same benefits per aca law. Covers pre ex. Only difference is easier direct carrier enrollment platform and silver plans are cheaper off market to avoid silver loading plans on market. Google it

Used to be ppo plans avail off market only, that went away in 2017

Providers don't understand aca.

All other plans off market are scams or 3 month STM plans which I won't touch

 

[Yagents]

I have only done ACA, But I am told off exchange is important too
I have have several ask about it, one told me they work in multiple states
I have also had several medical providers tell me personally marketplace plans don't cover as much and are not well liked

But I never hear about this from agents or FMOs what's the skinny?
what's good what do I need to know
what are the benefits of buying off exchange?
Does it cover out of state?
does it still cover pre ex?
who are the carriers ?

Of course availability also depends on state and county, etc

 

[vic120]

Of course availability also depends on state and county, etc

I do buis in 25 states

I am currently doing ACA as ref mostly in most FFM states and GA

However I have not done others states ACA in non FFM states( with the exception of GA)

Because I really just don't know all what's involved

I do not currently market for U65 health, But I do buis in Medicare and FE in multiple 25 states an get referrals all the time

in Non FFM states I just don't know what I can and cannot do U65

 

[vic120]

I stopped writing off market years ago.

Had a few tell me they have high income and then lost their job or income and expected an aptc refund. Ummm.....sorry you won't get the $10,000 aptc refund since we didnt buy on market since you told me $300k of expected income and didn't want to enroll thru thru the govt.

The same carriers and appointments that have on marketplace plans have off market plans.
There are no hidden carriers. All have same benefits per aca law. Covers pre ex. Only difference is easier direct carrier enrollment platform and silver plans are cheaper off market to avoid silver loading plans on market. Google it

Used to be ppo plans avail off market only, that went away in 2017

Providers don't understand aca.

All other plans off market are scams or 3 month STM plans which I won't touch

I will tell you here in OH since I moved here last year I have run into it a LOT from providers

I used to have Molina and they were saying I have Medicaid, I say no I don't have Medicaid, Ohh but you bought it on the exchange we don't take Medicaid but we do take CareSource on the marketplace

which is a lot more expensive but I got it this year

and just yesterday, a specialist said I just want to make you aware you just have marketplace CareSource they don't cover a lot, you don't get as much if you need therapy and all these items she went though

So I thought since this keeps coming up I should investigate

Also I just had a ref, she had 3 families in her buis and was trying to see if individual made sense this was in TX

But wanted PPO plans with national coverage had heard these were offered off exchange

and I got the same rebottle 6 months ago on another referral, she was in NY so nothing I had there for U65 anyway

 

[Jim Wright]

You can get PPO off exchange in a lot of states but it's typically just the blues. Some states are now offering PPO's on exchange. NC, SC BCBS have them on. Networks are the same on or off ex.

In general plans are the same on and off. Sometimes there are differences but there won't be many. In NC, BCBS has an off ex only plan that is fantastic.

 

[Chazm]

In FL the only way that I know of to get a PPO is off exchange. I got FL Blue PPO last January and I only see hmo or epo on exchange.

 

[Yagents]

In FL the only way that I know of to get a PPO is off exchange. I got FL Blue PPO last January and I only see hmo or epo on exchange.

Blue options ppo is on market also

 

[Yagents]

I will tell you here in OH since I moved here last year I have run into it a LOT from providers

I used to have Molina and they were saying I have Medicaid, I say no I don't have Medicaid, Ohh but you bought it on the exchange we don't take Medicaid but we do take CareSource on the marketplace

which is a lot more expensive but I got it this year

and just yesterday, a specialist said I just want to make you aware you just have marketplace CareSource they don't cover a lot, you don't get as much if you need therapy and all these items she went though

So I thought since this keeps coming up I should investigate

Also I just had a ref, she had 3 families in her buis and was trying to see if individual made sense this was in TX

But wanted PPO plans with national coverage had heard these were offered off exchange

and I got the same rebottle 6 months ago on another referral, she was in NY so nothing I had there for U65 anyway

Dude, listen to what you're saying.

1. Providers have no idea what they are talking about, or if it's ON or OFF market, and the networks are the same, and the coverage is the same per ACA EHB's law.

2. Medicaid networks are different then ACA networks, even with the same carrier. Same with MAPD vs ACA.

3. "They don't cover a lot" means most of their patients have high deductibles on ACA plans, or the plan doesn't cover the benefit, even with EHB mandates.

4. Group vs individual is a comparison of premiums, network, and if the EE's are eligible for APTC

5. PPO does not mean nationwide, and are rare in the ACA market. BCBS AZ is a STATEWIDE PPO at 2.5 x the premium.

As I said, the only major difference is if client paying full premium, and wants or needs a silver plan. Same plan OFF market is 20% cheaper to avoid Silver loading on the exchange.

Also, write OFF exchange, and run the risk of the getting the call, my accountant said I'm eligible for APTC refund after filing. Umm, no you're not because you bought OFF market.

You need a better mentor, or upline

 

[Chazm]

Blue options ppo is on market also

Maybe it's because I used healthsherpa to look but my blue select ppo 1442 wasn't listed. My wife is a Fl blue captive agent and we had to do it off exchange. But you're right. Blue options is on there.

Wish I could have kept my old pre ACA Fl blue plan. But wife and kid got in the way.