Opinion: Look Past Premiums to See How Health Insurance Will Change in 2014

In case you missed it, October 1, 2013, marks the launch of the health insurance marketplaces where people can start signing up for subsidized coverage or the expanded Medicaid program. We can finally take stock of the new coverage options -- their prices and benefits -- and see if the Expedia-like Healthcare.gov will function as promised.

There was a surge of news last week when the U.S. Department of Health and Human Services (HHS) released information onpremiums for selected plans to be offered on Healthcare.gov. At first look, the premiums look like a big improvement over the status quo. For example, a “silver plan” (designed to pay benefits amounting to 70 percent of the cost of the average enrollee) will cost about $260 per month for a single 27-year-old, even before any subsidy. The same plan for a family of four with middle-aged parents would cost about $943.

By way of comparison, in today’s non-group coverage market, the most popular comprehensive plans would cost nearly twice as much, roughly $460 per month for the 27-year-old and about $1,866 for the family. While not exactly an apples-to-apples comparison, the new premiums look good.

But as attractive as these premiums are, they do not tell the whole story. The federal data release, for instance, did not tell whether the examples shown have narrow or broad provider networks. In addition to deductibles, whether one’s doctors and other providers are “in network” is one of the most important considerations in selecting a plan. Some plans will not pay for out-of-network providers at all and others will have high patient cost-sharing to go out of network. All of this information is available on Healthcare.gov, so it is important for consumers shop carefully. Many will find attractive plans at good prices, but others may find premiums on their preferred plans do not look quite as good as the ones the feds published.

 Read more at NJSpotlight.com