Ask Nancy: Where can I find good health insurance?

Jul 1, 2010 11:21 AM

Q: I believe I would qualify for the new high-risk pool since I have been uninsured for more than six months and have a pre-existing condition. Where and how do I apply?

Q: Where can my nephew go to get healthcare insurance? He is self-employed, married, has two children, and is low-income.

A: At last, there's an easy way to answer questions like these. It's called healthcare.gov, it went live this morning, and even though it won’t dole out a penny in subsidies, or have the power to make a recalcitrant insurer write an affordable policy for an adult with a pre-existing condition, it still represents a gigantic step forward for consumers. Until now, incredibly, there has been no single, comprehensive listing of health insurance policies available to individuals and small businesses who are not eligible for Medicare. Anywhere. Period.

"We have more than 1,000 insurance carriers offering 5,561 products open for enrollment," said Todd Park, chief technology officer at the Department of Health and Human Services and the mastermind behind the new site. "It was developed in 90 days, which is crazy, with the benefit of a ton of consumer input—18 focus groups in five locations, and two full days of beta testing."

You can go on this exceedingly easy-to-navigate website—brought to you courtesy of a provision of the Affordable Care Act—enter your state of residence and answer a few questions such as how old you are, whether you have a serious health condition, and whether or not you’ve had trouble affording insurance, and get back a comprehensive list of options both public and private. These include:

Private individual and small business health plans. You can see every plan sold in your state (insurance is regulated and sold on a state-by-state basis), along with:

A link to coverage particulars.
A link (if the company provided one) so you can find out if your doctor participates in the plan.
A link (again, if the company provided one) to the plan’s preferred drug list. -Web addresses and phone numbers to contact for more information.

If you check out the offerings in your state, you’ll see that some companies did a much better job than others of supplying the information HHS wanted. In too many cases, for instance, companies provided non-working (or no) links to doctor lists and drug formularies. Some coverage links lead to helpful, clear sites like this one from Kaiser Permanente of Southern California. Others lead to sites like this head-scratcher. Let’s hope that carriers who blew off HHS’s requests for information are embarrassed enough to do better in the future. If they don’t, you might consider what that says about their commitment to customer service.

One big question I had was whether junk health plans would somehow sneak past the eagle eyes of the experts at HHS to gain a spot on this list. I can’t be sure that nothing slipped through, but I just did a spot-check for junk plans that know are being sold in specific states, and they didn’t make the cut. Later this year, the site will expand to show cost-sharing information for each plan (things like copays, coinsurance, and deductibles); more detail on benefits; and standard rates for customers in good health. Even farther down the road, you’ll find information on customer satisfaction and plan quality.

High-risk pools. There are links to all the new state high-risk pools for uninsured people with pre-existing conditions, and, for the 21 states that elected to let the federal government operate their pools, a link to application forms. You’ll also find links to the existing high-risk pools operating in 34 states.

Medicaid and CHIP. There are links to these programs in every state. This in itself is a huge convenience; from experience, I can tell you that state Medicaid and CHIP sites are not always easy to find starting cold from a search engine. But these features are just the beginning of the site’s riches.

Almost as important is the material that explains your rights and options if you find yourself in a health-insurance crisis, such as losing coverage from your job or getting to the end of your COBRA benefits. It’s right there on the home page, in the box entitled "Your Health Care, Explained." From the questions we’ve been getting here on this blog, it’s clear that employers and insurers too often get away with denying consumers their rights. So read up and be empowered.

There’s also excellent information about the Affordable Care Act itself, written in non-legal language and cut into digestible pieces so you can easily access the parts that apply to your situation.

—Nancy Metcalf, Senior Program Editor

Take a look at our updated health-reform timeline, and if you're insured, read more about the health coverage changes you can expect.

Photo: HealthCare.gov