I have ACA coverage now, and had it in 2020 when I made a trip to Mayo Clinic. Mayo was out of network, insurance wouldn't pay anything, so I investigated gett

I have ACA coverage now, and had it in 2020 when I made a trip to Mayo Clinic. Mayo was out of network, insurance wouldn't pay anything, so I investigated getting private insurance, figuring I could force a "life event" if necessary to switch insurance coverage outside the open enrollment period. I ran into lots of roadblocks: Part of ACA is that insurance companies can no longer refuse coverage or charge more for pre-existing conditions. IMO the insurance companies agreed to this because everyone was going to be forced into either buying insurance or paying a penalty to be self-insured (not carry insurance). The penalty was later removed by Congress, but the insurance companies were stuck with the no pre-existing conditions rules. https://www.hhs.gov/answers/health-insurance-reform/can-i-get-coverage-if-i-have-a-pre-existing-condition/index.html https://www.hhs.gov/answers/health-insurance-reform/can-i-ge... When I tried to get private insurance from major carriers, I ran into: - circular phone trees that couldn't be escaped - forwarding to "agents for my area" that never answered the phone - forwarding to agents that did answer the phone but said there would be coverage limits for 6 months since I had a pre-existing condition. This is illegal. One agent did give me a quote for $2400/mo with a $10K deductible. - I did find prices on the Internet that said private PPO coverage would cost about $800/mo with a $10K deductible, but no insurance company would actually write it. IMO, only writing new individual coverage (not via company employment) during open enrollment is a way for the insurance companies to keep their limit on pre-existing conditions. I ended up paying cash ($12K) for a 1-week visit to Mayo. In hindsight, paying cash was a better deal than if I had private PPO coverage: PPO would have cost $9600 in premiums (or more!) plus I would have paid the first $10K, so nearly $20K. Insurance in the US is a mess! I do have to add though, ACA has been a lifesaver for me.