Obamacare is a bummer. I am bummed out by all the bad news. The healthcare.gov fiasco is a disaster for people who want to shop for health insurance. It is all bad and I am very depressed.
Lucky for me that I’ve been busy with my Medicare clients, but I’ve also been looking at options for my limited number of clients who are under 65 and have, or want, individual health insurance. But without the healthcare.gov website functioning, it’s a lot of work to look at all the options. But I have looked at all the health insurance plans in the Tucson market and I have been pleasantly surprised by Health Net.
Health Net’s website is not user friendly and you must search very hard to find information on their individual health insurance plans. I stumbled across their “rate sheet” in a list of forms as well as the details of their plans. A shopper can look at their plans, all 16 of them, ranging from PPO Platinum plans to HMO Basic plans. Here’s how to find details on their plans at Healthnet.com.
Many of Health Net’s plans are 40% or 20% plans that make everything subject to the deductible until the deductible is met. Then the co-pay is 40% of the bill, or 20% of the bill until you hit the max-out-of-pocket. These are lower-cost plans, but they are a lot like the high-deductible, bare-bones plans that are offered today.
But Health Net has a number of plans that have co-pays for many services. I call this “real insurance” because these plans are more like employer plans. One plan I like is the “HMO Silver $30/$50/$2,000.
EXAMPLE WITHOUT A SUBSIDY
I have a client who is 59-years old and makes too much money for a subsidy. She can get the Health Net HMO Silver plan “$30/$50/$2000″ for $346.57 per month. This plan has unlimited doctor visits for a co-pay ($30 for primary care/$50 for specialist); $2,000 deductible; $6,350 maximum out-of-pocket per year; labs: $20 co-pay; x-rays: $50 co-pay; CT/MRI: $250 co-pay; mental health visits: $30 co-pay; ER: $400 co-pay. Hospitalization is subject to the $2,000 deductible.
This Health Net plan costs less than what she pays now for a plan with 3 doctor visits per year for a co-pay and a $5,000 deductible. Everything but the 3 doctor visits comes under the deductible, meaning her current plan protects her against catastrophic medical bills – but it cannot compare to the Health Net plan she can get in 2014.
EXAMPLE WITH A SUBSIDY
I have two clients who are married and currently paying around $400 per month each for the plan with a $5,000 deductible and 3 doctor visits per year for a co-pay. They can get the same Health Net HMO Silver plan “$30/$50/$2000″. Based on their ages, one will have a premium of $310 and the other $346. That totals $656, but they should qualify for a $175 subsidy, leaving them with a premium of $481 for both of them. Divided by two, that is $240 each. So their premiums will be almost cut in half and they will get a very good health insurance plan.
TUCSON: A COMPETITIVE MARKETPLACE
I have looked at the plans offered by other companies selling individual health insurance in Tucson through the federal Marketplace, and nobody comes close to Health Net’s plans and pricing. But it appears to me that Health Net was expecting healthcare.gov to do its marketing by showing plans side-by-side. If a person could compare Health Net plans to its competitors’ plans, it would be no contest. But Health Net’s website doesn’t allow someone to shop on their own as does Humana, Blue Cross Blue Shield, Meritus, and the University Health Plans.
By the way, I can never remember what the name is for the University plans, so it was a challenge for me to even find their web site. And at this very moment I have tried to google them to get the correct name without success. But when I did find their web page last week, I found their plans to be like current everything-comes-under-the-deductible plans with no options like the comprehensive designs of several of the Health Net plans.
So, if you know someone who is shopping for health insurance, they should just call Health Net and get a quote. If they don’t qualify for a subsidy, they can go directly through Health Net. If they qualify for a subsidy…. I’m hoping the healthcare.gov website will be working soon.
When I write about Medicare and Medicare Advantage, I’m not allowed to name names because of all the marketing rules set up by Medicare. As well, there is no one Medicare Advantage plan that stands out from all the others. There is no “best plan”. But I have been shocked to find that only Health Net is offering such comprehensive plans and such reasonable prices. Not all of their plans are comprehensive, but there are several I would enroll in if I needed health insurance. People need to know this information, so I decided to write about it.