Comparing health insurance plans to become easier in 2012
>> Sunday, September 11, 2011
If you've tried shopping for health insurance, you know how frustrating it can be.
Experts say much of the language isn't in plain English and too often the actual costs are hidden or unclear.
But come next March, shopping for health insurance should become much easier.
Under the federal health care overhaul adopted in 2009, health insurance companies and employers who offer health coverage to workers will be required to provide clear and consistent information about your health plan.
The information will include:
"It's absolutely a great idea," said Lynn Quincy, senior health policy analyst at Consumers Union. "It's a really big issue that consumers face when trying to compare health insurance plans."
By making the terms of insurance plans easier to understand, consumers are less likely to find themselves in health plans that don't meet their needs, she said.
"Consumers Union has heard too many stories of consumers that purchased a health insurance plan that they didn't understand," Quincy said. "Creating this health insurance disclosure will help reduce
The new form will also list common medical scenarios, such as pregnancy, cancer and diabetes, and will include information such as premiums and patient cost-sharing, and cite the bottom-line cost for treatment of those conditions.
Health insurance companies said they strive to make their materials understandable and worry that the rules will burden them with unnecessary paperwork.
"Health plans increasingly provide user-friendly online tools and clear materials to make sure that consumers understand the benefits and costs of their health insurance policies," said Robert Zirkelbach, spokesman for America's Health Insurance Plans, which represents the industry. "The benefits of providing a new summary of coverage document must be balanced against the increased administrative burden and higher costs to consumers and employers."
Until the new form takes effect March 23, 2012, here's how to shop for health insurance:
Assess your needs: The insurance needs of a healthy 25-year-old man are very different from those of a woman planning to have children or a person with a chronic illness.
That young man may not need all the "bells and whistles" in a plan if he doesn't go to the doctor very often, said Keith Mendonsa, consumer specialist with eHealthInsurance.com.
If you take lots of prescription drugs, "you will want to buy a plan that will offer you prescription drug coverage and will help you pay for it," he said.
If you have a pre-existing condition, it's critical to factor that in, because some pre-existing conditions can make it difficult to get approved for health insurance.
The good news is that starting in 2014, all health insurers will have to sell coverage to everyone who applies, regardless of their medical history or health status.
At that time, insurers won't be allowed to charge more to individuals with pre-existing conditions, nor will they be able exclude coverage of those conditions from the insurance plans they sell.
Compare carefully: "Once you assess your needs, that's when you start comparing," Mendonsa said.
"The best way is to pick a small group of insurance plans and really compare them side by side so you can have a really good idea of what you're looking at," he said.
Until the new requirements take effect, Quincy recommends that consumers "create their own side-by-side comparison."
Be sure that your doctor is in the insurance company's network.
Also, consumers "should have a good understanding of the coverage exceptions," Quincy said.
Review the costs: It's critical to know how much the policy will cost -- and how much can you afford. Look at the policy's:
Health insurance is essential for everyone to have, so do as much homework before purchasing a policy as you would before buying a car.
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