Tuesday, April 8, 2014 at 7:35 AM
Many people who've enrolled in health insurance through the new government exchanges already had private insurance. We don't know how many yet…but those who switched did so because their old plan got cancelled due to changes in the law, or they got a better deal on the exchanges. ideastream health reporter Sarah Jane Tribble is here with the story of one those who's getting a better deal.
A good sticker shock
Before deciding to sign up for an insurance plan on Ohio’s federally-operated exchange, Elizabeth Manning had watched her insurance premiums climb nearly 40 percent in two years.
By December 2013, Manning was paying $562 a month for her individual insurance with a $2,500 deductible and putting on some needed care.
Still, it was not an easy decision to look for new insurance on the exchange, she says.
“I had had so many people tell me, ‘Oh no, your rate is going to go up.’ I even had people in the insurance business tell me. I would tell them my demographic - I’m in my late 40s - and they said that my premium would go up and I was really surprised that it went down,” Manning says.
Manning, who is the executive director of Rocky River Chamber of Commerce, said she is now saving about 125 a month in premiums and her deductible is lower. And that has meant a lot just in the last month or so.
“I had some medical procedures that I needed to have done and my deductible was $2,500 and when I went on the exchange I ended up getting plan where the deductible was $1,000. So I was able to get that effective Feb. 1 and have these procedures done and they were all covered!,” she says.
Manning was careful when choosing a plan. She first signed on to healthcare.gov and spent some time filling out the application. Then she took the time to make sure her prescriptions and doctors were covered on the plan she chose.
In the end, she signed up for a plan that was very similar to what she had before and she describes a pretty seamless transition.
Not all positive sign ups
With reports from across the country that many enrolling for coverage are finding higher-than-expected out-of-pocket costs up front, experts are warning that people must analyze the plans before choosing. (See below). Tips include checking the list of covered doctors and drugs as well as calling the insurance company directly for answer to questions.
A happy ending
Manning says she believes her success on selecting a plan comes from her own expectations of what to expect and her ability to shop around.
Manning, who has a chronic inflammation of the sinus passages, also benefit from the Affordable Care Act’s rule that insurance companies cannot determine coverage based on preexisting conditions.
“When I went on the exchange there’s no question about your history whatsoever. Which was fantastic, so they’re not pricing based on what prescriptions I’ve taken or what procedures I’ve had done in the past so it was such a relief,” Manning says.
Note: In the coming weeks, ideastream’s WVIZ will air stories about people using the exchange as part of its ongoing Be Well project.
“Be Well: Choosing Right Exchange Health Plan Can Be Tricky,” March 18, Sarah Jane Tribble
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