Finally! You can now see health insurance plan information without going through the entire registration process for healthcare.gov.
Put in your state, county, and age and it shows you all the plans available, sorted by lowest-to-highest-premium. Each plan shown has an overview of co-pays, deducictibles and MOOPs. Links are provided to the plans’ summary of benefits and a provider search tool.
This is great news! Here is the link that takes you to the healthcare.gov page to get plan and premium info.
That is step 1, and the next thing you need to do (or maybe you want to do this first) is to get an estimate of the premium subsidy to help you with your health insurance costs. This requires you to use another website provided by the Kaiser Family Foundation which has developed a subsidy calculator.
How to understand health insurance lingo:
When you see the name of a health insurance plan, you can get a sense of how it will cover your medical expenses and what you will pay. If you see “$30/$50″, this means you will have co-pays for doctor visits. “ 40%/40%” means you will pay 40% – but this is after you have met your deductible. I don’t like these kinds of plans because you end up not wanting to go to the doctor because you know your bill could be $100, $200, or more. Plans with $ co-pays for doctor visits are more like employer plans.
Any time you see a dollar amount ($), that is what you will pay and that service is not subject to your plan deductible. Percentages (%) mean you pay a percentage of the bill after you have met your deductible. These % plans will generally have lower premiums.
Click the link for the plan Summary of Benefits to get more details.
As an example, here is the Summary of Benefits for the Health Net Silver HMO plan $45/$65/ $1500 deductible. This plan is kind of like an employer plan because various services have co-pays rather than being subject to the deductible. Diagnostic tests: $65; MRI/CT scan: $250; Emergency Room: $250.
There is one thing about the Summary of Benefits for this Health Net plan: It looks just like the Blue Cross Blue Shield layout and color. This is weird. Health Net’s Summaries of Benefits have a different layout and use the color green for all their materials. For some reason, Healthcare.gov has put all the plans in the BCBS colors. That’s weird for me to see other companies’ plans looking like they are BCBS plans with their layout and color scheme.
I suppose having the same layout for each plan will allow you to print out a few of the summaries and look at them side-by-side. When you do this, be sure to compare the Health Net Silver plans (with $/$/$ in the name) to other companies’ Gold plans. Write the premium on each sheet so you can compare the monthly premium, co-pays, deductibles, and MOOPs.
Beware of “Maricopa” plans if you live in Tucson.
For some reason, healthcare.gov is showing plans for the Tucson market that have “Maricopa” in their name. Do not enroll in a “Maricopa” plan if you live in Tucson! BCBS has plans with a particular network in Maricopa county – but they are showing up on the Tucson list. Anyone who enrolls in these plans must use doctors in the Maricopa county network!!
So go shopping and see the plans in your area side-by-side. There are some great prices in the Tucson market – even before you subtract your subsidy!