Here is a story that I have not heard reported in the news at all, and I am very surprised because I find it shocking. And that is: plans offered through the exchange, and directly from your health insurance provider might have exactly the same name, but they may cover different things and have different costs.
As of early this morning, I thought I had the ACA (Obamacare) figured out. I had finally been able to access the web site on day 3 after trying many times before that. I had picked a plan, sticking with my current insurance company, and was pleased to see that my monthly cost would go down by about $80 and I would get prescription medicine coverage which I don't currently have. Huzzah!
After choosing the plan, I called my insurance company to ask them whether it was better to buy the plan online, or go straight to them. The woman I spoke to said that it didn't matter; that it was the same plan. I said okay, that I would think about it some more and either buy the plan online or call back once I had made my final decision.
Today, I decided to call my insurance company and get the plan over the phone, since I've heard stories about how the website isn't quite reliable yet when it comes to actually purchasing a plan. I reached someone who reviewed the plan with me (the high level stuff), and then I asked for a quote to verify that we were talking about the same exact plan at the same exact price I had found online.
Well, the price he quoted me was almost $100 more. What? I explained I wasn't seeing the same prices on the website. We reviewed some other plans. Again, the pricing was different. Not just the monthly cost, but also the copay. Confusion abounds.
I told him I'd need to do more research. He gave me his number to call, which was different from the one I'd originally called, so I called the new number. Got a different person, who was able to explain to me that the plans offered through the exchanges are different from the plans offered directly from the insurance companies, even though they have EXACTLY THE SAME NAME.
Apparently the silver 2500 plan I had found on the exchange, when purchased directly from the insurance company includes pediactric dental. And that costs almost $100 more a month? That sounds fishy to me! And, what's the deal with the different copay?
This experience is jarring. I now don't trust any of the information I'm getting either from the website or directly from the insurance companies. I'm very very confused. I told the guy on the phone, I'm very very confused. He said, yeah it's confusing. If the insurance companies are confused, what hope do we have?
Apparently when you buy through the website you are buying a plan "in the exchange". If you buy a plan directly from your insurance company, your plan is not in the exchange.
Perhaps I'm stupid, but I thought the point of the ACA was that every insurance plan is in the exchange so we all share in the cost of insurance. And if that's not true, then why do the Republicans have their knickers all in a twist, if the insurance companies are continuing to offer plans outside of the exchange? I don't get it.
If only, if only, if only, we had a single payer system. It would be so much simpler, and so much cheaper, and so much better.
Instead, we are left with this confusing mess.
And why are no news sites reporting this disparity between "in exchange" plans and out of exchange plans?? How is a consumer supposed to know the difference? These differences were not explained to me in any of the printed materials I received from my insurance company; they were not explained in the information on the website, and they were only explained to me when I called my insurance company back for the third time.
