New Pennsylvania Tool Compares Health Plans On And Off The Exchange

Dec 12, 2016

HealthPlanRatings.org goes beyond the federal exchange by focusing on costs, rather than just premiums.
Credit HealthCare.gov

Pennsylvanians looking for health insurance have a new option to help them find the right coverage. HealthPlanRatings.org is a plan comparison tool created for the state by nonprofit Consumer’s Checkbook.

Unlike HealthCare.gov, the site ranks policies based on an estimated total annual cost rather than the premium alone.

“This website really focuses on—given the information you’ve given us—here’s how much we think, based on this plan, you’re going to pay out of pocket in a year,” said Teresa Miller, Pennsylvania's insurance commissioner. Miller said that she's impressed with the tool.

Like HealthCare.gov, HealthPlanRatings.org asks for a shopper’s age, sex and zip code. But it also goes one step further by asking about the doctors they use, medications they take, and what procedures they expect to need in the coming year.

The tool also asks users for their general health status, providing them with the choices of excellent, very good, good, fair and poor. Those categories are based on a survey used by a Medicare survey.

“It turns out that what they say about their status is a very good predictor of how much health care they will use,” said Robert Krughoff, Consumer’s Checkbook president.

The nonprofit has been providing health-care-insurance cost comparisons to federal employees for 37 years and recently branched out to private insurance. It also evaluates doctors, hospitals and non-medical professionals such as plumbers.

Consumer’s Checkbook will maintain the tool for free for one year.

“We really wanted to test some different options,” Krughoff said. “One important thing is that we are comparing, not only plans that are on the health insurance exchanges, but also plans that are not on the health insurance exchanges.”

Miller said that is one of the reasons why she likes the price comparison tool.

“Because in some areas where you only have a couple of options on-exchange, there might be a better option for people who aren’t getting subsidies off-exchange,” Miller said. “And now there’s a website that will make it easier to shop for plans both on and off.”

The Affordable Care Act health care exchange in southwestern Pennsylvania only includes plans from UPMC and Highmark.

HealthPlanRatings.org went live on Monday, Dec 5. Open enrollment for Medicare and the Affordable Care Act runs through the end of January, but the site will remain active through October of 2017, when details of the 2018 plans are released.

The deadline to enroll in a plan that would take effect on January 1st is Dec 15.