This may help: How Is Health Insurance Marketed in California? Health insurance coverage is marketed to consumers through individual policies or group policies. Individual health insurance coverage should be pursued when your employer does not offer health insurance as a benefit of employment, when you cannot be named as the dependent on another personÂs insurance policy, or when you are not a member of a professional or trade association that offers group coverage. Many consumers are self-employed, contract employees, or work for small employers and do not have access to a group policy secured by an employer. Individual coverage can be obtained by contacting a licensed health insurance agent or broker. You will need to complete an application that includes your medical history, which will be reviewed by a medical underwriter at the health insurance company. If you meet the underwriting qualifications and are issued a policy, the company may not cover preexisting conditions up to one year after the effective date of the policy. However, if you have been previously insured under an individual or group policy without a break in coverage of more than 62 days, your new insurance company must apply the prior creditable coverage (refer to the "Health Insurance Terms" on page 15) towards any waiting period for preexisting conditions. Individual health insurance companies may reject your application based on your medical history. Group health insurance offers certain advantages over individual health insurance policies. The waiting period for preexisting conditions is six months, not one year as with individual policies. Also, if you have been previously insured under a group policy without a break in coverage of more than 180 days, your new insurance company must apply the prior creditable coverage toward the six-month waiting period for preexisting conditions. Large employer group health insurance (more than 50 employees) and association group health insurance, like individual health insurance, is subject to medical underwriting. You can be denied coverage based on your medical history. Medical underwriting rules for small group health insurance (2-50 employees) differs from large group and individual health insurance policies. Regardless of any preexisting condition, you must be offered coverage under a small group policy on a guaranteed issue basis. However, the small group insurance company can utilize the six-month waiting period for preexisting conditions. Of course, if you have prior creditable coverage it must be applied to decrease or eliminate the waiting period. CA.Gov

I read your link tom418 (which is to a blog, BTW), and I stand by what I said. There are many HDHPs available in Mass, but they do have to meet minimum standards. That by no means makes them "deluxe" policies, to use your term. For example, in order not to trigger the tax (or fine, if you prefer), a MASS HDHP: must not limit benefit payments because an individual develops Alzheimer's, mental illness, alcoholism or other chemical dependency after the policy is issued; it can't have a pre-existing condition limitation that lasts for more than six months after the policy's effective date; it must be guaranteed renewable or non-cancelable, etc, etc. Standards like these are a long, long way from demanding that people can only buy "delux" plans, which is what your post claims. What will happen and who will pay their health care costs if one or both of the Williams eventually develops Alzheimer's and their policy doesn't cover it and they, themselves, run out of money? Why should the rest of the taxpayers of Mass pay for them just because they opted for the cheapest type of insurance they thought they could get away with? Apparently, the plan the Williams couple has doesn't meet the minimum standards, but there's just no way to tell why from your link because no further info is provided. So given that you don't have the foggiest idea what their plan covers and doesn't cover, your question "In what way would a high -deductable plan (like the MA couple I mentioned had) be useless?" can be answered, "Don't know exactly, but maybe in a lot of ways."

I have not only ours, but have been over the years caregiver for both my mother and aunt. I'd highly recommend keeping them for at least several years. Just about a week ago, I got an EOB from her supplemental for Aunt (who died in Jan) for a service that was performed in Dec. Reasons you need to keep them for a while: not all facilities bill promptly--you often need to go 6 months back to make sure benefits are coordinating properly; if you end up in an estate situation, you sometimes need those records; often you think a bill is taken care of, an the facility thinks it's NOT*; also, aside from the financial aspects, those are a great addition to your health record (what year was it I had my appendectomy?)--everything is on them, and you can refer to them. There's also the tax stituation--you need to be able to verify your health deductions--what you paid, what was paid for you, etc. *We've had a problem with this just recently. I was in the ER last August, DH paid the bill IN FULL, IN CASH and got a Paid in full receipt the beginning of SEPT (2011). We've been billed at least 5 times since for a portion of that bill. Each time we've addressed the issue, sending proof we paid it--and been told the matter was cleared off our account. And just a few weeks ago, I got a letter saying they would be turning the matter over to collections--I have been told one more time that our account is cleared. The gal I spoke to seemed surprised that I wanted written proof (????????) I got a printout of the account with a 0 balance, but I'm not wholely convinced yet.... I cannot tell you how many times, for one reason or another, I've had to refer back to those records years later. I'd hang on to them--neatly organized, of course.

As roarah says, all states are not equal. I live in a state whose gov. has done everything he could to stymie the ACA & refused to expand Medicaid - leaving many of our citizens w/o access to coverage. Also, our insurance commissioner is reportedly prohibited from regulating the insurance 'providers' - essentially allowing them to gouge consumers. If it were not for the ACA, I would not have insurance (had none for over 30 years before now) & I've already made good use of it. My individual plan is costing approx. $4400/yr, but I'm paying only about $800 of that w/ the subsidy. Not to let anybody off the hook, but I think the biggest culprit is medical costs - which continue to balloon out of control, it seems. Insurance providers, & ultimately we, are definitely paying through the nose for services & prescriptions. I was recently in a hospital room for about 6 hours - not even an overnight stay & no meals & the charge for that my ins. co. paid was $23,000! Has anyone else heard about the new push to require providers to disclose prices? The prediction is that this may result in lower costs - eventually. Right now, the $$ charged for a procedure can vary as much as 70% or more... http://www.npr.org/blogs/health/2014/02/12/276001379/elusive-goal-a-transparent-price-list-for-health-care Oh & love him or hate him, I recently heard a good 1 from Ralph Nader: isn't it ironic to be calling the folks who gouge everyone on medical costs 'providers'?