Affordable Care Act
The Health Reform Story You Haven’t Heard
Published on February 13, 2015
The February 15 deadline for the Affordable Care Act is rapidly approaching.
For the health insurance industry, the anticipated flood of last-minute shoppers could turn this Valentine’s Day weekend into Obamacare’s version of “Black Friday.” Perhaps, Pink Sunday?
For those who find themselves without health insurance, or unhappy with the plan they got last-year, the trick for this weekend will be to avoid long hold times and slow, confusing web sites when they shop for health insurance on government exchanges.
The “Secret” Places to Shop for Health Insurance
What most Americans don’t know is that they can get the same health insurance plans at the same prices, and receive their government subsidies, without shopping on a government exchange.
A handful of licensed web-based health insurance brokers – essentially private, non-government exchanges – offer the same policies at the same prices as the government sites, plus additional plan choices. They also provide an easy way to shop for plans and apply for government subsidies online.
One of the big benefits of shopping “off exchange” is that you’ll have access to a wider selection of health insurance plans. Government exchanges only show the health insurance plans that can be bought using a government subsidy.
By comparison, eHealth has a total of 6,429 major medical health insurance plans that meet all of the government benefit standards — including more than 1,900 plans that are not available on Healthcare.gov in the 33 states that use the Federal Exchange.
The plans sold off of the government exchanges must meet the same minimum benefit standards as the exchange plans. But, the plans can differ when it comes to things like access to doctors, out-of-network coverage, or visits to specialists.
Roughly one-in-eight people who bought health insurance at Healthcare.gov last year didn’t qualify for a subsidy, so they might have benefited from seeing more health insurance plans – not just the subsidy plans sold on the exchanges.
Earlier this year, eHealth announced that it had made it much easier to apply for a government subsidy on eHealthInsurance.com, and that people were completing the entire application in as little as five minutes from their smartphones.
This is another difference that stands out from the government sites. Despite much improvement in the enrollment processes, there are still reports from consumers and media about “back-end problems” that continue to make “the enrollment process cumbersome” on the exchanges.
The Internet generation expects shopping online for health insurance to be as easy as shopping online for books or shoes or t-shirts. The right way to shop for anything is to spend time looking at your options and reading some of the product details, before you buy. The purchase process shouldn’t take hours to complete.
What to Look For When Shopping
Getting the Best Price
If price is your number one issue, and it is for many people, you should try to estimate whether or not you qualify for a subsidy at both federal and private marketplaces.
At private marketplaces like eHealth, you can input your zip code, gender, date of birth, the number of dependents on your tax return, and an estimate of your taxable income for 2015. With that information, a private exchange like eHealth can estimate your monthly savings and show you plans in your area at their estimated price, after the subsidy is applied.
It’s important to note, that price of a health insurance plan must legally be the same no matter where you buy it. There are no discounts for buying direct from the insurance company or from a broker like eHealth.
Keeping your doctor
One of the things we hear in the news all the time is that access to doctors is limited with the plans sold on exchange. In a recent study, about one-in-ten people who bought insurance at eHealth.com said they switched plans this year in order to keep their preferred doctor.
If your doctor is important to you, when you’re comparing health insurance plans make, sure you check the plan’s provider network to see if your doctor is covered by that plan. Be aware that doctors can enter and leave these networks all the time, so it’s idea to check with your doctor directly.
Another way to keep your doctor is to look at plans that offer out-of-network coverage. Plans with out-of-network coverage will pay for covered medical expenses you receive from a doctor or hospital, even if they’re out of network. But, your cost-sharing – deductibles, coinsurance, co-pays, etc. – may be higher and you may have to file the claims yourself with the insurance company.
Getting good advice
If you want to enroll in a health plan that really meets your needs and covers the things that matter most to you, it’s never a bad idea to talk to a real human being.
While the government exchanges are staffed with “navigators” who can answer your enrollment questions, these navigators are not licensed health insurance agents. Why does that matter? An agent who is licensed can legally recommend a plan to you, based on your specific needs. Legally, a navigator cannot do that.
This may not seem like a huge issue if you’re young and healthy, but if you have specific medical issues, like children with asthma, or a family history of breast cancer, advice from a licensed agent becomes critical.
All of the web-brokers are staffed with licensed agents who can answer your questions. The benefit of working with an agent employed by a web-broker is that the agent will have a lot of different insurance companies and health insurance plans they can recommend.
At eHealth, you can explore your options for health insurance plans by entering your zip code where indicated on the right side of this page or get a free health insurance quote here. Or, you can sign up for our newsletter on the right side of this page, too.