Individual & Family
Group health
Medicare Supplement

Best rates GUARANTEED

Free Assistance 800-320-6269

California health insurance  -  Covered California Questions  -  difference between in and out of Exchange health plans

What's The Difference Between In And Out Of Exchange Health Plans?

This is a great question and we're still getting answers on a daily basis as the actual roll-out of the ACA law occurs. Let's look at the core differences (few) and similarities (many) and potential advantages either way. First, we need a lay of the land.

Quick Summary of Exchange and non-Exchange Marketplaces

The Exchange is really the new "marketplace" for California health insurance. You can think of the non-Exchange plans as the existing marketplace although under new rules and requirements.  You're going to see Metallic plans mentioned which refers to the standardized benefit levels (Platinum, Gold, Silver, and Bronze). If a carrier offers a plan in the Exchange, they must offer that exact plan out of the Exchange. Let's first talk about what is the same between in and out of Exchange plans.

In and Out of Exchange Plans Similarities

  1. The Plan Benefits for an equivalent metallic plan must be the same both in and out of the Exchange
  2. The rates for equivalent metallic plans must be the same
  3. The networks for equivalent metallic plans must be the same

Essentially, these plans, rates, and networks will be identical between like plans both in and out of the Exchange. So what's different?

Differences between In and Out of Exchange Plans

  1. Availability of health subsidies if eligible are only available in Exchange
  2. Availability of cost sharing benefit if eligible is only available in Exchange
  3. Enrollment process is simpler out of Exchange if not eligible for Subsidy

So what are the primary drivers of going either in or out of the Exchange?

There are large subsidies in Covered California if your income is below a certain range

California health insurance ratesNumber One is the Health Subsidy and Cost Sharing Benefit. If you qualify for either (gross income between 138% and 400% of the Federal Poverty Level - see Covered California income grid), you really should get an Exchange plan and we can help you with this more complicated process at no cost to you.

Call 800-320-6269 and find out your CORRECT subsidy amount in 5 minutes

Otherwise, the enrollment process for non-Exchange plans will be simpler and that's probably the better route. Either way, we can help you evaluate both options especially taking into account Health Subsidies and Cost Sharing Benefits. There is no cost to our service and having a guide to this process will help ensure that you do not overlook or miss out on the best value.

You can run your Covered Ca Health Plan Quote here to view rates and plans side by side from the major carriers...Free.

Again, there is absolutely no cost to you for our services.  Call 800-320-6269 Today!

YOU MAY STILL BE
ABLE TO ENROLL

In just 15 minutes:

  • - Get the most tax credit available
  • - Find the best plan for your needs
  • - Enroll right over the phone!




Call 800-320-6269

Our Services are FREE to You!

Need Help
With Existing Account

We can help you:

  • -Get required docs to covered Ca.
  • -Make changes to income and other info
  • -Choose and finalize plan enrollment
  • -Make sure you get right tax credit
  • -Payment/membership issues with carriers

Call to Enroll over the Phone in 15 Minutes

If Your Income
Is In This Range

Current Years Estimate; All those that file together on one 1040:


Single Person: $16k - $47k
2 People $22k - $64k
3 People $27k - $80k
4 People $33k - $97k

Call 800-320-6269
Anthem Blue Cross California
Blue Shield of California under Covered California
Kaiser of California
Health Net of California
Aetna
and more
Thousands of Californians
Hundreds of California Companies
SUCCESSFULLY
ENROLLED
Thousands of Californians
Hundreds of California Companies

from SC

"My sincere thanks for making a miracle happen- 2014 health insurance !! Many thanks for your expertise and advice yesterday !!"

from SD

"Thanks again for your help - I had absolutely no idea how to get this done when I got up this morning. You've made it remarkably easier than I expected. I hope you're not stuck at the office all night..."

from KV

"Anyway, I hope you got some time off this past week! Thank you again for your help and efforts on my behalf! I was very lucky to find you."

from EK

"I thank you very much for the time that you have invested in handling everything

from SR

"I truly appreciate the quick response and will think of you in the future if I need to make any changes to my insurance plans."

from VH

"You are awesome... takes a huge worry off my back, thank you for your kind. thanks for your time and kindness. !!"

from SA

"Wow, I can't thank you guys enough for your help...I couldn't imagine trying to tackle this on my own!"

from LM

"You are my new best friend. A HUGE thank you again.

SUCCESSFULLY
ENROLLED
Find out what customers are saying about our services
About Calhealth.net

20 years of experience in the California health insurance market has taught us one thing...Competent and experienced guidance is Invaluable

We can quickly (very important) size up your health insurance needs and clearly explain the options available to you. Our focus is finding the most coverage at the best cost to you.

We are licensed Covered Ca agents with in-depth knowledge of their plans, process, and tax credits.

Call us...you will be Pleasantly Surprised.  800-320-6269

Request a 10 Minute Health Plan Check-up

We'll quickly see if you have the best priced plan available and if you qualify for a tax credit

800-320-6269
calhealth website

Our Services are FREE to You

Calhealth.net is a Goodacre Insurance Services Website

This website is owned and operated by Goodacre Insurance Services, which is solely responsible for its content. This site is not maintained by or associated with Covered California, and Covered California bears no responsibility for its content. The email address and phone numbers that appear throughout the site belong to Goodacre Insurance Services, and cannot be used to contact Covered California.