6  Things  You  Didn’t  Know  About  Buying  Health  

Insurance    

What  They  Might  Not  Tell  You  

Ê Obamacare  health  insurance  plans  may  look  the  same  at  the  core,  but  there  are  details  you  should  know  before  you  decide  on  a  plan  or  automatically  renew  the  coverage  you  have.    

Ê When  open  enrollment  begins  Nov.  15,  2014,  re-­‐asses  your  current  health  insurance.          Like  …  

The  lowest  price  plan  may  not  be  the  best  for  you  

Ê A  low  monthly  premium  price  =  high  deductible  and  high  out-­‐of-­‐pocket  expenses.  Not  ideal  if  you  have:  Ê an  ongoing  medical  condition  Ê tend  to  be  ill  and  need  medical  care  several  

times  a  year  Ê   have  small  children  who  need  to  see  the  

doctor  frequently    

The  lowest  price  plan  may  not  be  the  best  for  you  

Ê According  to  HealthPocket.com,  in  2014,  the  average  deductible  amounts  for  individual  and  family  health  insurance  plans  sold  on  34  state  exchanges  were:  Ê Bronze  plan  –  $5,081  (individual);  $10,386  

(family)  Ê Silver  plan  –  $2,907  (individual);  $6,078  (family)  Ê Gold  plan  –  $1,277  (individual);  $2,846  (family)  Ê Platinum  plan  –  $347  (individual);  $698  (family)  

The  lowest  price  plan  may  not  be  the  best  for  you  

Ê Average  monthly  premiums  before  any  applicable  subsidies—for  40-­‐year-­‐old  individuals  in  the  same  34  states  were:  Ê Bronze  plan  –  $295.51  Ê Silver  plan  –  $319.42    Ê Gold  plan  –  $377.63  Ê Platinum  plan  –  $388.29  

 

The  lowest  price  plan  may  not  be  the  best  for  you  

Ê Using  this  data,  the  40-­‐year-­‐old  individual  could  pay  $286.92  more  each  year  moving  from  a  Bronze  to  a  Silver  plan  and  reduce  the  deductible  by  $2,174.  

Ê That’s  8  percent  more  in  premium  for  a  nearly  43  percent  decrease  in  annual  deductible.    

Deductible  Ranges  

Ê Reminder:  Ê  Bronze  –  the  plan  pays  60%  of  covered  medical  expenses;  the  

consumer  pays  40%  

Ê  Silver  –  the  plan  pays  70%  of  covered  medical  expenses;  the  consumer  pays  30%  

Ê  Gold  –  the  plan  pays  80%  of  covered  medical  expenses;  the  consumer  pays  20%  

Ê  Platinum  –  the  plan  pays  90%  of  covered  medical  expenses;  the  consumer  pays  10%  

Some  carriers  offer  low  prices  the  first  year,  then  increase  pricing  

Ê  Enrollment  impacts  health  insurance  premiums.    

Ê  Insurance  companies  need  to  ensure  there  are  enough  healthy  enrollees  to  balance  the  cost  of  sicker  enrollees.  

Ê   When  setting  their  rates  in  2014,  health  insurance  carriers  had  to  make  predictions  about  their  enrollee  demographics.    

Ê  They  based  their  rates  on  the  projected  risk,  not  actual  data.    

Ê  If  companies  lost  money  in  2014,  they  may  need  to  increase  rates  in  2015.    

Your  provider  network  is  always  changing  

Ê  Just  because  your  preferred  doctor,  clinic,  hospital  or  specialist  participates  in  your  health  plan’s  network  does  not  mean  that  will  always  be  the  case.    

Ê Networks  change  from  year  to  year.  Some  health  care  providers  and  facilities  will  no  longer  participate.      

Ê Many  insurers  use  narrow  networks  on  exchange-­‐based  plans  to  make  them  more  affordable.  

Ê Check  your  network  and  be  sure  you  still  have  access  to  the  care  you’ve  been  receiving.    

You  may  need  to  switch  your  medication  to  a  different  brand  or  generic  version  

Ê The  medication  you  take  now  may  not  be  covered  next  year,  even  if  your  plan  currently  covers  it.    

Ê Prescription  drug  formularies  change  from  year  to  year.    

Don’t  pay  =  no  coverage  

Ê There  have  been  glitches  in  the  enrollment  systems  for  both  state-­‐based  and  federally  facilitated  health  insurance  exchanges.  

Ê   Many  people  sign  up  to  have  their  premiums  automatically  withdrawn  from  their  bank  account  and  then  never  check  if    payments  are  being  made.    

Unless  you  are  getting  a  large  subsidy,  plans  on  HealthCare.gov  or  your  state  exchange  may  not  

be  the  best  option  

Ê  Health  insurance  plans  sold  away  from  HealthCare.gov  or  your  state  health  insurance  exchange  may  be  cheaper—and  they  offer  the  same  benefits.  You  can  buy  from:  Ê  HealthCare.com  Ê  healthinsurance.org  Ê  eHealthInsurance.com  

Ê  Only  plans  sold  on  the  state  or  HealthCare.gov  offer  premium  tax  credits  and  cost-­‐sharing  subsidies.    

Ê  However,  if  your  income  makes  you  ineligible  for  financial  assistance,  you  should  consider  checking  rates  for  health  insurance  plans  sold  in  the  private  marketplace.    

About  HealthCare.com  

Since  2006,  HealthCare.com,  a  privately-­‐held  technology  company,  has  been  committed  to  improving  online  healthcare  for  U.S.  consumers  making  purchasing  decisions.  Our  goal  is  to  help  consumers  easily  research  information  and  compare  health  insurance  quotes  from  nearly  200  health  insurance  carriers  using  interactive  tools  and  an  intuitive  search  interface.  We  offer  trusted  recommendations  and  a  comparison  shopping  experience  to  simplify  decision-­‐making,  allowing  consumers  to  find  the  right  health  insurance  plan  that  fits  their  lifestyle.  To  provide  customers  a  first-­‐rate  user  experience,  our  technology  uses  proprietary  algorithms  and  data  to  advocate  the  best  and  most  affordable  insurance  options.  We  also  offer  free  online  calculators  and  shopping  tools  to  make  healthcare  buying  easier  and  more  efficient.  We  partner  and  integrate  with  industry-­‐leading  health  insurance  companies  to  help  consumers  enroll  into  plans.  All  of  HealthCare.com’s  leading  technology,  tools  and  services  are  free  to  consumers.  For  more  information,  visit  www.healthcare.com.