Obamacare Fear: Dare to Compare Plans?
NEW YORK ( MainStreet) Now that I have circumvented the Healthcare.gov website and completed my application old-school via snail mail, I am ready to buy health insurance. But, without a processed application, the system isn't ready for me.
Premium prices shown incredibly misleading
As I found out first-hand, the Healthcare.gov "see plans now" tool is not helpful at all.
"It is largely useless and misleading to consumers because the sample premium prices shown are most likely not accurate and it displays no other plan comparison information," says Jonathan Wu, C.E.O. of Valuepenguin.com, a consumer finance site that specializes in helping consumers make decisions about insurance. His company easily built an exchange plan comparison tool to show more accurate premiums and plan specific benefits based on location, exact ages, income and family size, which includes any likely subsidies applied.
The main problem is the Healthcare.gov "see plans now" tool only offers two age options: Under 49 or over 50.
"Consumers don't know that the sample prices shown by the tool are really based on someone age 27 for the first option, and someone age 50 in the other," Wu said. "Actual premium prices depend on exact income, age and family size and will most likely be very different once your application is processed."
In this case, someone 45 years old will pay substantially more than some aged 27, and someone whose family size is larger than the sample of four will also see higher actual premiums. The same goes for the age samples in the other family options. Also, the Healthcare.gov tool does not show any subsidies applied, so consumers may experience premium sticker shock that is not warranted.
Two things that do not affect premiums are health status and gender.
Deductible sticker shock is real
According to the Healthcare.gov tool, most plans offered in my county are from the BlueCross BlueShield of Florida, which shows a benefit and cost chart for each plan on the company website. That's when a new sticker shock hit me: ridiculously high deductibles for Silver plans. Healthcare.gov clearly explains that Bronze plans likely have lower premiums and higher out-of-pocket costs and that Platinum plans have the highest premiums and lowest out-of-pocket costs. The deductibles listed on most of the Silver plans were in the $11,000 range for a family and in the $6,000 range for singles (and only $1,000 less for the highest-priced Silver plans), almost as high as the maximum out of pocket costs for the plans. That's only affordable if you don't use the plan at all and never pay it.
I called up Florida Blue at the 800 number and spoke to customer service agent Danielle Anderson, who very patiently explained that any eligibility for a premium subsidy might also bring further "cost-sharing" reductions in the deductibles (specifically for Silver plans, according to Healthcare.gov), which also depend on the processed application.