In a
post earlier this week, I threw out an option for those that are unhappy with their employer's health insurance plans. Today, I started the shopping process so that when open enrollment begins, we'll be ready to compare what is available in the private market alongside what my wife's employer will be offering this year. To make this easy, I've collected screenshots to deliver a nice step by step look at the process to find a policy.
Also, we'll be putting in an application this weekend as well so that we'll know if we're approved for the policy or not. After speaking with one of eHealthInsurance.com's agents, the approval process can take anywhere from one to three weeks depending on how much digging they need to do to verify your application and medical history. So here's the process (which was about 15 minutes):
Step 1: Enter Your Zip Code
Since insurance is regulated by the states (this is a bad system...more on that another day), you need to enter your zip code so eHealthInsurance.com can find the policies that are available to you.
Step 2: Enter Family Information, Select Coverage Type, and Enter County
This information is the first step in the underwriting of your policy. Underwriting is the process through which insurance companies identify and quantify your risks based on innumerable data.
Step 3: Best Sellers are the Default, Select 'Help Me Choose' Tab
This is a sales process, but rather than try to sift through dozens of policies, it's easier to use eHealthInsurance.com's 'Help Me Choose' function.
Step 4: Help Me Choose Overview
This set of questions is designed to filter policies based on the criteria that you input. What's really nice is that the monthly premium is listed for the least expensive option matching the criteria along with the number of policies available.
Step 5: Ongoing or Temporary Insurance
Here you select whether you need a policy that is only temporary or more permanent. Sometimes, if you are unemployed you might select temporary to obtain a policy to fill the gap in employment. However, if you are looking to change over to a policy that can be renewed annually, select 'ongoing'.
Step 6: Available Insurers
In this step, it's important to select all insurers so you have the most options available to you. While you may hate a particular insurance company, I don't believe that you'll necessarily find a better experience elsewhere. At this stage, try to keep an open mind.
Step 7: Health Savings Account (HSA) Option
Here again, I wouldn't exclude any health plans based on the availability of health savings accounts. In general, you want to keep as many options on the table as you can unless you feel very strongly one way or the other on this issue.
Step 8: Basic or Comprehensive Coverage
This is largely a function of your pocketbook. If you can afford comprehensive coverage, select it. Even if you can't afford it, the price differences aren't necessarily astronomical as seen on this screenshot. Ultimately, comprehensive is more expensive, but some policies can offer comprehensive care at a low premium up front, but you can expect higher deductibles or co-insurance rates.
Step 9: The Dreaded Deductible
Your health insurance deductible is the amount you need to pay before insurance starts to pay out. The general rule here is to select the options that you are able to afford based on (1) the amount of the deductible and (2) the amount of the premium. Remember that you MUST be able to afford the premium and the deductibles are a secondary concern.
Step 10: Co-Insurance Rates
Co-Insurance rates are usually 10%, 20%, 30%, etc. and this represents the percentage that you need to cover AFTER the deductible but before the annual out of pocket maximum. For example, if you have a 20% co-insurance rate, a $2,000 deductible, and $5,000 annual out of pocket maximum, you would pay the first $2,000 on your own (that's the deductible), then the next $15,000 of medical expenses would be paid 80% by insurance ($12,000) and 20% by you ($3,000). For us, we opted out of co-insurance because it annoys me.
Step 11: Optional Coverages for Prescriptions and Maternity
If you want your plan to cover prescriptions or a pregnancy, you need to select this as a required coverage. For us, we'll take the prescription coverage, but not maternity (this problem was fixed a while back).
Step 12: Prescriptions Payment Options
We aren't into percentages, so a flat dollar co-pay works fine for us. This is entirely up to you, but I definitely prefer a known dollar rather than an unknown percentage.
Step 13: Click 'Show My Recommendations'
Step 14: Review Recommended Plans, Search for Doctors
When you get to this stage, there should only be a small number of plans remaining. You can review the plans, but more importantly, you need to search for your doctors to be sure they'll accept this kind of insurance. If you find the doctors you want, continue on.
Step 15: Compare Plans for Coverage
Always remember that insurance must (1) have the coverage you need and (2) be at a price you can afford. In this step, it's important to carefully compare coverage offered which can be accomplished by clicking the check box next to 'Compare'. This will put up to four policies side by side to make the comparison easier. If you want the details, plan brochures are also available at the bottom of the comparison pages.
Step 16: Analyze Costs
If the coverage you need is available, the final step is to compare costs. To do this, open a spreadsheet or do your own by hand that will account for the monthly premium, annual premium, deductible, out of pocket maximum, and the total cost. An example is below, and as you can see, we like the second option which is $2,100 less expensive than the first and $550 less than the third. Of course, these are worst case numbers, but that's what we are protecting against - a financial calamity caused by medical costs.
From here, we will put in an application (in our case the electronic application is free). Since each insurance company has a different application, this is where we'll end the process for the purposes of this post. However, even if we are approved, we'll still be waiting to see what the policies look like from my wife's employer.
