Health Insurance Guys: What's the best medical plan choice for this family?

Dear Tom, Alan, and Kyle: My husband and six-year-old son are on a Blue Shield plan we've had for years.

I hear about Covered California and open enrollment. Is that something we should be exploring?

Our "grandfathered" plan costs us about $700 per month and all our doctors take it, but it does have a large deductible. Our income fluctuates. Right now it's around $5,000 each month.

My question is should I risk not being able to get my current plan back if I go to Covered California?

Cindy

Tom: The quick and easy answer is, probably not.

You are correct that if you do give up your grandfathered plan you won't get it back. Also, Covered California is available (more or less) every year from November through January for open enrollment. So if something goes awry with your current Blue Shield plan in the future, there is an option.

Al: Of course the cost factor can weigh heavily on your decision as well. For your household of three with an annual income of $60,000, the "shop and compare" tool on the Coveredca.com website indicates a monthly subsidy of just short of $1,200!

This means your premium would be about $700 per month. In other words, if you were shopping for a plan directly with Blue Shield, it would cost you right $1,900 each month…but if you go through Covered Cal you only pay $700.

Kyle: Now hold on just a doggone minute. Cindy already pays $700 a month for a plan that nobody can get on any market, why would she change to a plan where she always has to report any ups or downs in income and where there is no guarantee of a future subsidy amount?

Furthermore, we've had people tell us of medical offices where they're told that they don't accept Covered California. They are wrong, of course, but it has happened.