The Norman Transcript

November 5, 2013

Presenting other ways to shop for health insurance

By Warren Vieth
The Norman Transcript

NORMAN — Looking for health insurance? Can’t get the Obamacare website to work?

There are other ways to shop. You can go directly to insurance company websites, where you’ll find coverage details and premium costs of every policy each company is offering both on and off the federal health insurance marketplace.

You also can contact an independent insurance agent, who can compare plans offered by several insurance companies and help you pick one that best fits your circumstances.

Neither option has received much attention in the initial rollout of the Affordable Care Act marketplace in Oklahoma and other states.

You may not be able to finish the process until the federal government’s bug-afflicted website is fixed, which may be weeks away. But at least you’ll be able to compare plans and premiums and receive estimates of how much your policy will cost after federal tax credits are figured in. If you know you’re ineligible for subsidies, you can enroll in a health plan now.

“They don’t have to go through the marketplace portal,” said Deputy State Insurance Commissioner Mike Rhoads. “They can go directly to the company websites and start that enrollment process. Or if they want to get all of the array of offerings out there, they can go to an agent who can shop that for them.”

“It’s really going to depend on the person and their own personal shopping preferences,” said Blue Cross Blue Shield spokeswoman Ashley Hudgeons. “For someone who is used to the online shopping-cart experience, that might be a good choice for them. For some people, it might be going to an agent or a navigator.”

One caveat: Insurance company websites might be a good starting place, but they can’t provide official calculations of federal tax credits and cost-sharing subsidies. For that, you’ll still need to go through the ACA marketplace by Dec. 15 if you want your policy to take effect on Jan. 1. (You can wait until March 15 and not pay a fine, but your policy won’t take effect as soon.)

Another caveat: Besides cost, one of the most important differences among competing plans is the number of doctors, hospitals and other providers participating in the “network” covered by each plan type.

Those networks vary by company and type of plan. Some Obamacare critics have expressed concern that individual policies offered on the federal marketplace may have smaller provider networks than the group plans offered by some employers.

The company websites let you enter the names of specific doctors or medical facilities to determine whether they are included in a plan. Some sites also let you enter a geographic location and will list all providers within a specified distance.

Plans with bigger provider networks tend to have higher premiums. In Tulsa, for example, Blue Cross Blue Shield offers higher-cost “Blue Choice” plans offering in-network access to several area hospitals. Its lower-cost “Blue Preferred” plans exclude St. John Medical Center and Saint Francis Hospital.

Five companies are offering individual health plans in Oklahoma through the ACA marketplace. Besides Blue Cross Blue Shield, they are Aetna Life Insurance Co., CommunityCare, Coventry Health Care Inc. and GlobalHealth Inc. Aetna acquired Coventry earlier this year, but they are still marketing health insurance as separate entities.

All five companies have websites with information about their plans and premiums. In some cases, companies list “on-exchange” and “off-exchange” policies with identical provisions and premium amounts. They also may have plans available only to ACA marketplace customers, or only to off-exchange shoppers.

To obtain policy details, you’ll need to enter your geographic location, your age, the ages of other people in your family who need coverage, and whether you use tobacco. Those are the only variables the government allows companies to use to calculate premium amounts, even for policies sold outside the marketplace.

Each company will show you a list of policy options. In northeast Oklahoma City, for example, a shopper can compare six Aetna plans, 19 Blue Cross plans, 12 CommunityCare plans, 16 Coventry plans and eight GlobalHealth plans.

The unsubsidized premium amounts for a 40-year-old single nonsmoker range from $154 to $507 per month. The plans are grouped into five coverage tiers — catastrophic, bronze, silver, gold and platinum — based on uniform ACA benefit criteria.

Oklahoma Watch is a nonprofit journalism organization that produces in-depth content on important public-policy issues facing the state.

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