Care to share the state or county? Kind of makes a difference.
ACA National PPO if available (doubt it) - Except FL Blue
Or Ambetter HMO which has coverage network reciprocity in 25+ states
Aetna and UHC will not have any PPO's or national networks. In most states, the blues will have them, usually only off exchange. Like Y said, Ambetter is national in the states they operate HOWEVER, the providers do not have to accept it from another state. If the DR is in GA and you have a plan from SC, they can refuse to accept even if they are technically in network.
First, all emergencies are covered out of network as long as they are billed as such.
If they break a leg out of state, likely the ER is covered but anything after that, they either pay full price or get back to their home state.
In my experience, most people don't really need any of that but they worry about it because they are used to having group insurance with a bigger network than they can comprehend.
I sell a lot of them with hsa plans which will be important in 2026 with 400% cliff coming back, and help reduce clawbacks and may be tax deductible premium
I sell a lot of them with hsa plans which will be important in 2026 with 400% cliff coming back, and help reduce clawbacks and may be tax deductible premium
An interesting thing I'm monitoring . Back in early 2020 when everything shut down I first took out aca . I stopped working like most . I put like $20 k estimated income for 2020 as nobody knew the future . I've not changed my silver plan nor touched my income since . Even though my premium $120 a month I pay the $900 a month clawback in estimated tax payments . I still get the awesome cost sharing so it's worth it . They've never make me adjust my income . I'm wondering if in 2026 they change that?
