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Comment by kvcrawford | Hacker News Reader

This neatly coincides with my need to purchase my own health insurance: I just accepted an offer with a startup that does not yet have a company plan in place, but they are giving me a a monthly allowance to purchase my own.

May I solicit any recommendations from the other hackers and entrepreneurs out there? Where have you bought insurance from? What private equivalents to the Health Insurance Marketplace are out there?

Right now I'm running through the application on eHealthInsurance.com and it's looking like I can get some pretty sweet PPO health insurance + dental + vision for about $212 per month.

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Are those for the 2014 calendar year? Everything changes then. As of last night, I was seeing 'good deals' on insurance from multiple places, but it was all 2013 numbers.

My understanding is that you need to have an 'ACA-compatible' plan, and in my state (NC) there are precious few, and effectively only one provider. HSAs are effectively gone (at least for me in NC - it looks like for others in NC as well) and my premium doubled for 2014.

Why are HSA's gone?

There's conflicting information out there. eHealthInsurance asks if this is for 2014 (or now), giving this reason for the question:

> With the introduction of the Affordable Care Act (Obamacare), plans in 2014 may be different from those offered now. You can no longer be denied coverage for pre-existing conditions, but you may incur higher premiums and find more limited offerings. Many insurance companies are allowing you to purchase plans now that can automatically be extended through 2014, meaning you will be able to keep your plan (and doctor) without worrying about the tax penalty in 2014.

According to HealthCare.gov, any plans instated after March 23, 2010 will need to change to comply with the new laws when you have to renew your plan in 2014. At least I think that's how it's working. See https://www.healthcare.gov/what-if-my-current-individual-pla...

Even more confusing is when I may or may not enroll for health insurance, inside or outside of the government marketplace. It looks like if you don't renew your plan within 30 days, you're not allowed to enroll anywhere (and I bet they'll even fine you for it! How nice!)

The lack of HSAs in NC is troubling - can you provide more details?

I called coventry, and they said they have an ACA-compatible HSA, but they had no info yet - getting a call on monday.

I'm pretty confused about this. I thought the ACA plans through the exchanges don't take effect until January (or later?). So do you need to buy a plan now on the exchange? And then buy a separate plan to cover you until then?

I guess that's how it would need to be. So, it's not perfectly neat. But I would probably be able to purchase COBRA to hold me off until 2014.

Still, individuals making more than roughly $45k (at current numbers) don't qualify for any subsidization. So purchasing through the government marketplace seems to be a moot point.

Is that the only benefit of the marketplace? Subsidies?

I was thinking they would have cheaper/better plans?

Yes. Cheaper/better plans == subsidies.

There are cheaper and better plans available, but ONLY if you make the income cutoff (~$45k for individuals with no dependents).

Whether you buy in or out of the marketplace has no bearing on the rules that healthcare plans have to follow. All healthcare plans must cover rules outlined by the act, or you will be fined.

What about paperwork? More or less?

Also the plans on ehealthinsurance can't require preexisting conditions ?

Haha, well, I'm having to figure out more government mandates, procedures, etc. to abide by now, so as it stands currently, more.

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