Letting in the Sunshine: Insurer Pricing, Denial Rates Now Available on HealthCare.Gov

Ed. Note: Cross-posted from HealthCare.gov

If you’ve ever searched for private health insurance, or even just tried to figure out which health care plan is a good fit, you know how hard it is to make heads or tails of what’s presented to you. There are a lot of terms, like “formulary,” that require visits to a dictionary or the internet. And it’s often difficult to figure out if the decision you’re making will actually give you value for your dollar.

Today, we begin to change that dynamic, and give more control to people instead of insurance companies. As of today, the Insurance Finder on HealthCare.gov includes information from over 4,000 private health plans offered by over 200 insurers, across all 50 states and the District of Columbia.

In addition to giving you the base price for these insurance plans, we have new details like the percentage of people who are quoted a rate higher than the basic premium based on the individual’s health status.  And you can see what percentage of people were turned down when they tried to buy that plan.  This will give you some sense of how different insurance companies change pricing and accept or deny coverage for individuals in less-than-perfect circumstances. Until today, that kind of information had never been available to consumers, and this new transparency is the result of regulations issued under the Affordable Care Act.

The Insurance Finder is designed to make it easy for you to see many of the things you need to know to make a decision about your insurance coverage. It includes helpful features that let you see specifically what benefits are excluded under the plan you’re considering, including benefits like maternity care and prescription drugs. To break through all the “insurance speak,” you can click on terms to see important cautionary notes and definitions. And you can select up to three plans and select “compare these plans” to see all their details at once.

We’ve also added information about Medicaid and the Children’s Health Insurance Program (CHIP) so that people eligible for those programs can see information such as cost-sharing for services. And in the future, we’ll continue to update the private insurance options available, as well as include information for small business owners.

In many ways, in addition to giving people more protection from the worst insurance company abuses, the Affordable Care Act is about letting people actually see what is happening in the health insurance market. Until now, too many Americans have lacked reliable information about coverage and faced confusing fine print and hidden limits when trying to sign up for or simply use their health insurance. Today’s unveiling of the updated Insurance Finder will shine some sunlight on the details of how these insurance options actually work. It’s a huge step toward making the health care system more transparent --- and making insurance companies more accountable to you.

Click on the screenshot of the tutorial below for more info on how the private insurance part of the Insurance Finder works, or head over to it and try it out right now.

HealthCare.gov Insurance Finder

Kathleen Sebelius is Secretary of the Department of Health and Human Services

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