Maggie's Farm

A health insurance broker I spoke to this week claims that there will still be companies offering off-exchange coverage of the major-medical type. The prices will be higher than last year, because all companies still will have to accept all comers regardless of health status, but the high-deductible option may help keep premiums down. He hasn't yet been able to send me any info on specific policies or rates yet, but he thinks he can get us insured through a company that's not participating in the exchanges here in Texas, United Healthcare. He also claims that United Healthcare has a better claims-paying record than our current insurer, Blue Cross, and that many doctors and hospital systems will be fleeing the Blue Cross network at the end of this year because of growing reimbursement problems.

I find this confusing. Certainly some aspects of the ACA's minimum-coverage rules will apply to all insurers, whether or not they participate in the exchanges. That includes, for instance, the ban on pre-existing condition exclusions. But according to this guy, the off-exchange policies need not fit into the Gold/Silver/Bronze boxes, especially in terms of maximum deductibles. Possibly they also need not cover aromatherapy etc., or pretend to offer a lot of "free" checkups, screenings, or vaccinations at the cost of jacking up the premiums.