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Old 11-08-2014, 12:00 PM
 
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I use to have Kaiser through my parents plan through their work but got cut off. Now I am through Covered California but the current plan I am on does not cover Eye Vision or Dental Plans. So what company and plan is worth going too that covers EVERYTHING?

The guys at Kaiser were talking about needing to get the deductable of $5,000 or something like that and nothing will kick in unless thats met or something I didn't quite understand.

So what plan would you recommend or do you use?
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Old 11-08-2014, 12:27 PM
 
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Platinum plan with adult dental. Will cost a fortune and not eligible for subsidies.
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Old 11-08-2014, 01:25 PM
 
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What plan do you think covers Eye Vision?
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Old 11-08-2014, 04:36 PM
 
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Probably none as they are not required to under ACA mandates. You could check with a broker for a stand alone plan, but you could not be subsidized for the cost.
I do better with Costco for my family's glasses than when I had vision coverage. Exam was $60 and the glasses were better than what I could get via insurance.
Sometimes specific insurance isn't worth getting . Better to just privately pay for it.
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Old 11-08-2014, 05:02 PM
 
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Well I need vision care that will check the eyesight and the inside and back of the eye ya know everything about your eye that needs to be looked at not just regular eye exams and glasses.
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Old 11-08-2014, 05:30 PM
 
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I just reread your OP. You might be confusing 2 different things here. If you have a deductible, yes you must pay the cost of the exam out of your own pocket until you spend 5K. After that the insurance company will cover some of the cost except for co pays or coinsurance you are responsible for until you reach max out of pocket expense.
You will be able to pay the contracted price the insurance company has with the eye doctor. He just can't bill you anything he wants.

What level plan do you have, catastrophic or bronze?

Purchasing insurance with lower deductibles costs far more in premiums each month. You have to decide if the amount of care you require each year warrants the extra expense. If you only see the eye doctor a few times a year @ $300 a shot, cheaper plans are fine. If you are going 12 times a year that is a different story and you'd probably be better off with a more expensive premium plan (but lower deductible)
Look up how often you went to Doctors over the past few years while under your family's plan. THat will help you decide what level tier (bronze, silver, gold) you should get. Subsidies are not available for platinum plans. Really low income people will get help with lower deductibles on silver plan only. Note you must purchase from the Exchange to get subsidies.
Enrollment for plans starting on 1/1/ 2015 starts on 11/15.

You can go to a broker who deals with the Exchange or via a navigator who can help you sign up with the Exchange. Bring ID with you.

Last edited by NSHL10; 11-08-2014 at 05:31 PM.. Reason: corrected info
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Old 11-09-2014, 05:34 AM
 
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Quote:
Originally Posted by disneygogetter View Post
Well I need vision care that will check the eyesight and the inside and back of the eye ya know everything about your eye that needs to be looked at not just regular eye exams and glasses.
Then no worries, you are covered. It's the prescription lenses and exam for them which are not covered but covered under "vision."
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Old 11-09-2014, 09:57 AM
 
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But the Covered California people said that no company under their name covered Vision and Dental.
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Old 11-09-2014, 10:16 AM
 
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They probably don't cover optometry visits/glasses for adults, but will cover a opthomology examination after you pay the deductible. Adult dental coverage requires buying a separate insurance policy that you can't receive a subsidy to help pay for it.
"Obamacare" plans have high deductibles. You will be paying for doctor visits out of your own pocket until you reach your deductible amount. Some plans will cover free visits to your primary care physician.

Go see a broker who enrolls people through the exchange. Discuss your wants/needs/income/budget and get the best plan for you.
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Old 11-09-2014, 04:31 PM
 
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I believe you are mistaken on their being a subsidy only offered on Silver Plans. Silver plans offer additional cost sharing subsidies when your income falls below 250% of the FPL, as well as the tax credit or Premium Subsidies, which are available on any metal group (Bronze, Silver, Gold, Platinum)
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