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Grandfathered employer healthcare plan is substandard and not affordable

 
 
Reply Fri 22 Mar, 2013 08:14 pm
My employers insurance plan will be considered grandfathered. However, I am an employee who works in a remote rural area and currently all of my coverage is considered out of network because united healthcare is not widely accepted. This means I may have what appears to be affordable healthcare but in reality it is not affordable and is substandard. It would be cheaper for me to buy from the state exchange because Blue Cross is offered and is widely accepted. It is my understanding that I will not be eligible for subsidies under the exchange because my employer provides a health insurance option. My household income would qualify me for subsidies otherwise. Is this true? Will i be forced to either continue paying out of network prices and not be able to benefit from better coverage under the exchange and the subsidies?
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Type: Question • Score: 0 • Views: 1,483 • Replies: 2
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InsuranceLady
 
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Reply Fri 20 Sep, 2013 03:35 pm
@Needanswerspls,
This answer is getting a workout. Razz


If your job-based coverage is less than 9.5% of your annual income, it is considered affordable and you would not qualify for the premium tax credit or cost-sharing from the Marketplace. However, if your job-based plan costs more than that or does not cover essential benefits, then you may enroll in the Marketplace.
roger
 
  1  
Reply Fri 20 Sep, 2013 03:57 pm
@InsuranceLady,
It may be getting a workout today, but it's certainly clear.
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