General Discussion
In reply to the discussion: This message was self-deleted by its author [View all]pnwmom
(108,955 posts)We were also working with an independent, whose emails to us had boilerplate on them about having to get approved to get the insurance. I finally asked about this, and he acknowledged that the law was changing as of January 1, 2014 so that they would have to take every customer, without regard to preexisting conditions.
But their email boilerplate still had the false information after Jan. 1. We ended up buying through the exchange. But another option might be better for you -- just not with your uninformed friend.
http://www.nytimes.com/2013/10/26/your-money/health-insurance-options-arent-limited-to-obamacare-exchanges.html?_r=0
In general, health policies effective Jan. 1, whether sold on the exchanges or off, must comply with the Affordable Care Act. That means they have to offer the same menu of essential benefits, like drug coverage and maternity care, and cant deny you coverage if youre already sick. And, insurers who sell policies both on and off the exchanges must sell the same plan for the same price.
http://www.insure.com/articles/healthinsurance/buying-health-insurance-outside-exchange.html?WT.qs_osrc=fxb-182807210
Drug coverage
Drug coverage is yet another variable. You may find you have more options when it comes to drug coverage if you shop off-exchange. Like provider networks, health plans can limit the drugs that are covered, or reimburse more for generics than brand-names, or reimburse more for drugs you buy mail-order than from your local pharmacy.
If you have a health condition and use a particular drug, you should check that it's covered under the plan in which you want to enroll, whether that plan is on the exchange or off-exchange, Coleman advises.
Remember, too, he says, the cap on out-of-pocket expenses doesn't apply to drugs not on a health plan's list of covered medications.