Health Insurance

Browsing Plans On Healthcare.gov Can Be Incredibly Misleading

Article on healthcare.gov from 2013.

Over the weekend Healthcare.gov was updated to include a button (highlighted in red below) leading users to functionality that will allow them to browse the plans available in their state and county. Users are asked basic information about where they live and the structure of their household, at which point they are presented with a list of prices and plans.

HealthGov.org

The tool and the prices shown however can be incredibly misleading for most consumers. For individuals browsing the plans, the only options are "49 or under" or "50 or over." Different prices are returned to the consumer based on which of the two options are chosen. Users browsing these plans are left with the impression that everyone under 49 will be paying the same price, when this is not the case. The premiums for insurance plans will scale based on your age, and 49 year olds will be substantially more than someone who is 27. Similarly, those consumers over the age of 50 will also pay different prices depending on their age. The sample prices being shown by the tool are only for someone age 27 in the first case, and someone age 50 in the second.

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A 48 year old from Alleghany County, North Carolina getting a quote using the new healthcare.gov tool, will see a $263.75 price for the Blue Cross Blue Shield, Blue Advantage Silver 3000 plan. This price however is really the price they would pay if they were 27. Instead the actual price for someone who his 48 years old will be almost 60% higher, around $410 dollars a month. Similarly a 60 year old in the same county, will see a premium price of $449.48 by using the tool on healthcare.gov. In reality however their premiums would actually be in the neighborhood of $683.00.

The premiums on healthcare.gov only accurately reflect premiums for very specific household makeups, yet there is no language, disclaimers or notices to let users know this is the case. For those that choose "You and Your Spouse" the sample household is two 40 year old individuals. The "You, your spouse and your children" is a family with two 30 year old adults and 2 children. If the age makeup of your household differs from these sample families then the estimates will not accurately reflect what your actual premiums will be.

Ironically the math necessary to scale the premiums properly for all ages is extremely simple. We've incorporated into our own exchange preview tools, so it is surprising that the HHS run site has not bothered to do so. Even more troubling is the lack of any language that would explain these details to the users. In the case of single person households, the prices shown are at the bottom end of each age range returning the lowest prices for those groups. In fact the only language throughout the entire site speaks to how costs may be lower for applicants with no mention that for some people these premiums will be in fact higher.

Jonathan Wu

Jonathan is the CEO and Co-Founder of ValuePenguin. He reports on an array of topics, including the financial services industry, healthcare reform, and financial products for consumers. He previously worked in the financial services industry, including at such hedge funds as Avenue Capital Group.

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