EXCELLENT: HC.gov window shopping to include In Network & Total Cost tools!
2018 MIDTERM ELECTION
Time: D H M S
For all of the improvements made to the federal exchange website, HealthCare.Gov, last year (ie, reducing the number of account creation screens from over 70 to just 16; optimized formatting for smartphones; working properly in general), there were still several major features missing. According to a new AP story, at least two of these have been addressed for the 2016 Open Enrollment period starting November 1st:
Consumers shopping on the government's health insurance website should find it easier this year to get basic questions answered about their doctors, medications and costs, according to an internal government document.
A slide presentation dated Sept. 29 says HealthCare.gov's window-shopping feature is getting a major upgrade.
...Previously, it could take considerable digging to find out plan details. Now consumers would be able to enter their doctors, hospitals and medications as they browse online. When they go to compare plans, they would see whether those doctors, hospitals and drugs are covered.
(Tips: Call the doctor's office and insurer to verify provider and hospital listings. And make sure to enter the correct name of any medications. For example, if it's a generic drug, enter the generic name.)
The revamped website will also have a feature that helps people get a rough idea of expected total costs. It takes into account not only premiums, but cost-sharing for services like office visits, and the deductible — the amount that consumers must pay each year before their insurance kicks in.
...The slide presentation said testing began last week with data provided by major insurers. Testing continues as the Nov. 1 open enrollment deadline approaches. Technical assistance is being provided to help insurers work through problems. The plan is for the new tools to function on smartphones and tablets as well.
Both of these new features will be hugely important. Complaints about doctors/hospitals/medications being "out-of-network" have been one of the biggest headaches of the ACA exchanges, and "Total Cost of Ownership" information (deductibles, co-pays & co-insurance) is absolutely crucial to take into consideration before deciding on a policy.
This news also partially addresses one of the biggest beefs which writers such as Andrew Sprung (aka Xpostfactoid) and myself have had with not just HC.gov but many of the state-based exchanges until now: The Cost Sharing Reduction factor. For anyone under 250% of the Federal Poverty Level...and especially for those under 200% FPL...Silver plans are usually a much better value than Bronze plans due to the way that the CSR subsidies work. However, until now, HC.gov and some state exchanges have promoted the monthly premium cost only on the pricing side. They still list deductibles/etc, of course, but the default display presented to the website visitor still tends to focus on premiums alone, which can be misleading. Thankfully, some state exchanges have addressed this by pushing people towards Silver plans right off the bat, but HC.gov is the big kahuna, serving 38 states this year (remember, Hawaii is pulling an Oregon/Nevada this time around by moving to the mothership).
I don't know exactly how the new HC.gov "total plan cost" tool will work or look, exactly; hopefully it will clearly lay out each of the costs as well as giving the total annual likely/maximum. While this wouldn't be quite as good as defaulting to Silver in the first place, it would at least make the deductible/co-pay factor much more obvious for window shoppers.