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Affordable Care Act

How Do I Shop for Insurance? More Listener Questions Answered

 In a Florida Matters show that first aired Tuesday night on WUSF 89.7 FM, a panel of experts answers reader and listener questions about the Affordable Care Act.

Our panel includes Health News Florida Editor Carol Gentry, attorney Linda Fleming of Carlton Field Jorden Burt in Tampa and Jodi Ray, program director of Florida Covering Kids & Families.

Florida Matters airs again Sunday at 7:30 a.m. on WUSF 89.7 FM in the Tampa Bay area; stream online from anywhere by clicking on “Listen Live” at the top left corner of this page. The entire show is available now at this link.

Among the questions we got by email and phone is this one from Chris Newman of Bradenton:

"I don't have any medical insurance, I used to but eventually it became too expensive for me. So I haven't had it for a number of years now, but I do plan on buying it. My question is...I'm having great difficulty comparing one plan with another. Many companies are contacting me, usually by mail. Unless there's some sort of spreadsheet where all the companies are listed, and I can compare one against the other...I just don't have the time to do it. So I don't know how one does it without physically speaking with every company that's out there offering health care. So that's the question: how does one choose which company to pick from when there's not some sort of spreadsheet where you can compare one against the other one, what services they are and what the prices are?"

CARSON COOPER: Alright, Jodi Ray, what about that? We’ve heard a lot about this, that it’s just hard to compare plans and prices specifically?

JODI RAY: Yeah, so we see that a lot with the consumers that we’re assisting, filling out the form and applying isn’t really where the challenges are. It’s sitting down and going through all the information about the health care coverage plan options that folks are being offered. I strongly recommend, and that’s the advantage of, using one of the trained assisters like a certified application counselor or a navigator, who have gone through a significant amount of training to be able to sort through the plans and explain them to the consumer and sort of ferret down to the key priorities that an individual has, and those differ from person to person.  

"One thing I would recommend, if you have a particular doctor, and you really want this to be your doctor, call her office, and see what plan she's in before you make the decision of which insurance company you're going with." -- Attorney Linda Fleming

But the navigator is able to actually help them narrow down what they’re looking at and then make a choice. They’re very neutral, they’re not recommending plans and they don’t work for a plan. They don’t get paid for recommending a plan. So they’re able to go through all the plans and give very impartial information to the consumer so they can understand why they’re making choices and what choices they’re making around deductibles, co-pays, provider networks, sometimes they’re looking at prescriptions that are covered.

COOPER : And Carol Gentry, the biggest questions are: is my doctor in this particular plan? What are my out-of-pocket costs? That’s what a lot of people really want to know.

CAROL GENTRY: One of the things you can do is go from healthcare.gov, you can actually click and go to a company’s site and see who the providers are. The trick is that most people who haven’t had health insurance in the past don’t understand that doctors and insurance companies are in a contract relationship and they can end that contract at any time. And so you’re signing up for a plan based on your doctor being in it but that could change, and there’s nothing we can do about that. That’s been the situation for years.

COOPER: Linda Fleming, have doctors had any questions about whether or not they are in a plan or are they clear on that?

LINDA FLEMING: I think they’re pretty clear on that. As Carol just said, there are contracts between the insurance companies and the providers, and that’s what these networks are, whenever we’re talking about networks and provider networks.  So, who has the insurance company contracted with? One thing I would recommend, if you have a particular doctor, and you really want this to be your doctor, call her office, and see what plan she’s in before you make the decision of which insurance company you’re going with.

More resources to help you understand the Affordable Care Act: