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Comment by muench | Hacker News Reader

COBRA means you’re still getting insurance through your (former) employer. How much does the same insurance benefit cost if you buy it fully on your own?

In my experience you can’t even buy a similar plan as an individual. And definitely not at the same price.

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Apples to apples comparison is very hard because the plans are all different. But having bought insurance from the state marketplace it two US states, I'd say around $500 USD/month.

This matches my recent experience. I researched plans on Washington state's health marketplace and found that while the available plans were generally much cheaper than COBRA, their coverage for out-of-network or out-of-state care was limited (e.g. "emergency" care only, where the definition of emergency is vague and up to the insurer). And even if you are careful to get taken to an "in-network" hospital, there are plenty of horror stories about inadvertently getting treated by an "out-of-network" provider while inside and being on the hook for the entire bill.

I couldn't find a marketplace plan that didn't give me real doubts about the possible financial impact of traveling to other states(!) so I decided to suck it up and pay for COBRA for peace of mind. Of course, COBRA will run out after 18 months, but I plan to get another corporate job before then.

TL:DR if you have (or recently left) a fancy corporate job here, you have access to a group plan with nice coverage. If you have to buy an individual plan, it seems you cannot get the same level of coverage even if you're willing to pay for it, and the available coverage leaves you with the risk of huge medical bills if you suddenly need healthcare while simply traveling within the country.

> . And even if you are careful to get taken to an "in-network" hospital, there are plenty of horror stories about inadvertently getting treated by an "out-of-network" provider while inside and being on the hook for the entire bill.

This is no longer legal in any state as of July 1st of this year.

> Bans out-of-network charges for ancillary care (like an anesthesiologist or assistant surgeon) at an in-network facility in all circumstances.

https://www.hhs.gov/about/news/2021/07/01/hhs-announces-rule...

I normally just lurk, but this could effect someone's plans and is slightly incorrect.

This change was enacted December, 2020 with a July 1 deadline to confirm it would be enacted.

It doesn't go into effect until January 1, 2022 and does not apply to charges incurred before then.

It also only applies to federal plans (including "Obamacare" plans, but not necessarily private plans.

The language of the subsection addressing this is poorly constructed, so be careful.

The HHS link provided above by secabeen has those details and links to further information

That is an improvement indeed. Thanks for correcting me!

I got a plan from the marketplace in Washington state for around 550/month. It was called a Silver plan, but it didn't cover very much. I kept getting bills a year after my services for things that I thought were covered and that my doctor said would be covered. And I looked into the benefits sheets while choosing my healthcare. Yes, I didn't get the highest priced one, but if Silver doesn't cover very much, I'm not confident "Gold" will. Also my experience with some corporate plans is that even though technically things are covered, sometimes the waiting times of a few months for urgent things mean they basically aren't.

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