ACA Compatible Plans with Wide National Network?

[Frappa Chino]

This is for my adult son who travels a lot. I want him to have a wide national network that covers all 50 states, that also covers major hospitals. We are willing to pay a high premium to get that, but I don't seem to be able to even find one with good coverage in IL, let alone nationally. I do NOT care about buying on the Exchange and will not be receiving a tax credit, though of course I hope the plan qualifies for whatever is required so he does not to pay a tax penalty.

Many plans seem to advertise themselves as a "national plan" but I don't know what that even means or how they are allowed to do it, because when I search such plans networks for other states, they come up with zero providers. Silly question, with all the laws passed by ACA, there is no requirement for ACA plans to cover more than the state it is issued in?

I live in another state and bought an individual plan not on the exchange but rather direct from United Healthcare that was compliant for tax purposes that gave me access to an outstanding network, I was hoping to do the same for my son.

Help!

Thank You!

 

[AllenChicago]

FrappaChino, if you son lives in Cook county Illinois, he can bypass the lengthy Healthcare.gov experience, and obtain a Harken Health plan that uses the United Healthcare PPO network. As you know, UHC's footprint is HUGE. Harken Health Insurance Company is a brand new subsidiary of United Healthcare, that's only available to Cook county residents.

If you send me a Private Message (see the upper right of your screen), I'd be delighted to assist you further.

-Allen

 

[YouGotMyMoney]

AllenChicago, why would you promote UHC when they have given every health agent the shiv? Great chance this Harken will close/shut down, before the end of 2015.

 

[AllenChicago]

AllenChicago, why would you promote UHC when they have given every health agent the shiv? Great chance this Harken will close/shut down, before the end of 2015.

I assume you mean 2016, YGM. Unlike United Healthcare, its Harken Health Insurance subsidiary did not give agents the "shiv". They're also building additional, new medical centers around Chicago in 2016. If you want to see more info, there's a Harken Health thread in this section.

Could Harken Health Insurance remove itself from the Exchange? Go out of business? Stop using agents? SURE! Every major medical health insurer in America will do at least one of these things in the next year, or so. ObamaScare is a burden to every health insurance company. We have to do our best with the hand we're dealt, YGM.

-Allen

 

[Frappa Chino]

Allen, thank you for the recommendation, I did check out Harken based on a mention I saw from you in another thread. I would PM you and gladly work with you but unfortunately he does not live in Cook County.

Do you know if any of the Coventry plans meet our requirements? Unfortunately their network finder requires the user to select from 1 of 50 networks, and it's not even 100% clear which network represents the plans they show for sale. The network I checked didn't seem to even have any major institutions in spite of the plans being twice the price of others (which I'd be willing to pay if it offered a great network). But it's possible I was not searching the correct network.

 

[Chazm]

I'm just browsing and I don't know your area, but typically Coventry has never had a large network.

 

[AllenChicago]

Allen, thank you for the recommendation, I did check out Harken based on a mention I saw from you in another thread. I would PM you and gladly work with you but unfortunately he does not live in Cook County.

Do you know if any of the Coventry plans meet our requirements? Unfortunately their network finder requires the user to select from 1 of 50 networks, and it's not even 100% clear which network represents the plans they show for sale. The network I checked didn't seem to even have any major institutions in spite of the plans being twice the price of others (which I'd be willing to pay if it offered a great network). But it's possible I was not searching the correct network.

FrappaChino, you're right. Coventry (owned by AETNA) is a patchwork of medical networks, but at least Coventry is a PPO in Illinois, whereas AETNA is only HMO in this state. As you probably know, PPO delivers much greater patient flexibility.

After posting this message, I will send you a forum Private Message (PM) along with a website where the correct Coventry PPO network will be automatically filled in, after you enter your adult son's zip code. We can then continue the discussion via PM, Phone, or E-mail, if you like.

-Allen

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I'm just browsing and I don't know your area, but typically Coventry has never had a large network.

In Illinois for 2016, Coventry's PPO network, and Land of Lincoln Health's PPO network, are larger than Blue Cross's individual plan PPO network. First time I've ever seen this. (All three were pretty much equal in 2014 and 2015)

FYI.. Land of Lincoln is the federal government designed co-op. It's running out of money. Cut off all indiv & small group enrollment on 12/31/2015.

 

[FRJ]

This is for my adult son who travels a lot. I want him to have a wide national network that covers all 50 states, that also covers major hospitals. We are willing to pay a high premium to get that, but I don't seem to be able to even find one with good coverage in IL, let alone nationally. I do NOT care about buying on the Exchange and will not be receiving a tax credit, though of course I hope the plan qualifies for whatever is required so he does not to pay a tax penalty.

Many plans seem to advertise themselves as a "national plan" but I don't know what that even means or how they are allowed to do it, because when I search such plans networks for other states, they come up with zero providers. Silly question, with all the laws passed by ACA, there is no requirement for ACA plans to cover more than the state it is issued in?

I live in another state and bought an individual plan not on the exchange but rather direct from United Healthcare that was compliant for tax purposes that gave me access to an outstanding network, I was hoping to do the same for my son.

Help!

Thank You!

You may want to consider a strong contender in his area and pair it up with an accident or indemnity style plan to help cover him in the event something happens while he's away from home. UHC has some interesting plans of this type but you could look elsewhere as well. For example, American General, Aetna, Medico, and other carriers also have similar plans. These types of plans can pay a cash benefit for a hospital admission, surgery, ambulance, fractures, etc.

I'm also in IL, covering mostly the NE portion.

 

[Frappa Chino]

Thank you both. The issue is he travels for extended periods, 2 months in one place, 2 months in another. He spends more time away than he does at home. So I want him to be able to seek out medical care where ever he is, not just for emergencies.

Harkin looks interesting but is not available in his county so that immediately rules that out. Coventry looks worthless, no coverage in any other state.

That seems to leave two BCBS PPO gold plans. IF their network finder is to be believed, their ACA plans have a ton of providers across all states, albeit none of the major hospitals. Both state that they are a "National Provider Network", yet one is explicitly named:
"Blue Cross and Blue Shield of Illinois, Blue Cross Blue Shield Premier 101, a Multi-State Plan"
The other:
"Blue Cross and Blue Shield of Illinois, Blue Choice Preferred Gold PPO 101"

Any idea why the one is specifically called out as a "multi-state plan" when they otherwise appear to use the identical network?

Thank You

 

[AllenChicago]

Frappa Chino,

You need to go back to Health Insurance Illinois | Blue Cross and Blue Shield of Illinois again, click on the "Provider Finder" link again and do a search with these three Medical Networks...

1. Blue Choice Preferred PPO
2. Blue Precision HMO
3. Blue Care Direct - Only Advocate medical providers are in this network.

Those are the only medical networks associated with Blue Cross Individual Plans for 2016.

The Multi-State plan uses the Blue Choice Preferred PPO network.

The Blue PPO Gold plan is only available to company-purchased Group Health insurance plans.

Up until 12.31.2015, many clients had the Blue PPO network. But they were converted to the Blue Choice Network on 1.1.2016. (Many BCBS-IL customers who don't have an agent, still aren't aware that this change was made! They saw their premium decrease a bit and smiled.)

As you've discovered, the "Blue PPO" medical network is the best that Blue Cross has, but unfortunately, it's no longer available to people who purchase individual health plans. Blue Cross decided to remove the Blue PPO from individual plans, rather than increase the premiums on those plans by 70%.