Compare your options with www.Healthcare.gov
Created by the Affordable Care Act, http://www.healthcare.gov/ brings information about private and public health insurance options into one place to make it easy for consumers to learn about and compare their options. http://www.healthcare.gov/ lets you compare an unprecedented amount of information about prices and coverage for private insurance policies, including:
- Monthly premium estimates;
- Cost-sharing information, including annual deductibles and out-of-pocket limits;
- Major categories of services covered;
- Consumer's share of cost for these services;
- Percent of people in the plan who pay more than the base premium estimate due to their health status; and
- Percent of people denied coverage
More resources to help you compare coverage:
- California Office of the Patient Advocate: Compare Costs
Consumers Union: How to Choose a Good Health Care Plan
Get group coverage if possible.
Buying coverage through a group lets you avoid medical underwriting [The process used by insurance companies to try to figure out your health status and determine whether to offer you coverage, at what price, and with what exclusions or limits] and generally leads to better coverage at lower cost.
The way most people in the United States get group coverage is through an employer; that's partly why the self-employed and those who don't get coverage at work have such a hard time finding affordable coverage.
Starting on January 1, 2014, California's Health Benefit Exchange will offer the benefits of group coverage to an estimated 4 million Californians who can't get it now.
Avoid plans that leave you underinsured.
Health insurance should cover hospitalization, doctor visits, emergency services, diagnostic tests, and prescription drugs. Plans that exclude any of these elements, or have very low benefit limits or very high cost-sharing, place you at risk of medical debt or going without care when you need it most.
More resources on underinsurance:
- Consumer Reports: Hazardous health plans: coverage gaps can leave you in big trouble
- Health Access: How to spot a phony discount health plan.
Understand how brokers work before you use one.
While many people find it helpful to use an insurance broker to help choose a plan, consumers should know how brokers are trained and paid before deciding whether to work with one.
In California, all it takes to become a licensed health insurance broker or agent is:
- a background check,
- 32 hours of study of the California Insurance Code, and
- 24 hours of continuing education every two years.
Licensed brokers and agents are trained on specific products by the insurance companies that sell them; this training may emphasize the benefits of the companies' products more than the gaps and shortcomings.
Licensed brokers and agents are paid on a commission basis by the insurance companies they represent. The commission structure pays twice as much for the sale of new products as for the renewal of existing products.
These information sources and incentives can conflict with a consumer's need for accurate, unbiased information about what a plan will cover, how much it will really cost and whether it will provide enough health care and protection from bankruptcy for the consumer.