Santa Fe, NM – Each year, consumers enroll or renew their individual health insurance plans and often have lingering questions such as how to choose which plan is right for them, will they get to keep their doctors, will the plan cover my medications, and the ultimate question for many, how much will the plan cost. The New Mexico Office of Superintendent of Insurance (OSI) has partnered with Consumers' Checkbook, a nonprofit organization with 40 years of experience helping consumers choose health plans, doctors, hospitals, and other providers, and has developed a plan comparison tool which will help address just these questions.
"With the shorter enrollment period this year, it is even more imperative that consumers, and agents and enrollment counselors assisting consumers, use every resource available to enable educated decision-making," said Superintendent John G. Franchini.
The plan comparison tool available at OSIcomparehealthplans.org allows consumers to compare plans available in their area providing details on the following factors:
- Estimate of average monthly and yearly total cost based on an actuarial estimate of premium and out-of-pocket costs for a consumer with the same family size, ages, health status, and other characteristics, which also factors in the potential for subsidies to help pay costs (about 70% of New Mexicans shopping on the Marketplace receive subsidies);
- Cost of plan in a high-use year, which estimates out-of-pocket costs if the consumer needs to make frequent use of the plan and the likelihood of that occurring based on health status and other characteristics disclosed;
- Doctor availability, which allows consumers to enter the names of their physicians to see which are in-network for each plan;
- Prescription Drug Formulary availability, which allows consumers to enter prescription drugs that they take to check if they are covered in a plan's formulary.
The tool features information for plans available both On-Exchange (beWellnm.com or www.Healthcare.gov) and Off-Exchange directly through the health insurance companies. This feature will be particularly useful for people who don't qualify for subsidies to reduce their costs. By using this new website, they can easily find out if a lower-cost plan is available to them off-exchange. Consumers are also able to narrow their choices to compare certain options side by side.
"Finding the best plan for your needs can be confusing, but this new, easy-to-use tool will give you a one-stop, full view of the details of plans and how their differences may impact yearly costs and access to care," said Franchini.
The OSI encourages all consumers to stop, shop, and enroll this year in the health coverage that best fits your needs. Although changes may come in the future, the need for health care will not. Be sure to check your eligibility for subsidies, and if you are ineligible for subsidies, be sure to shop and compare both On- and Off-Exchange plans.
"We are proud to partner with Consumers' Checkbook and illustrate that this type of plan comparison tool, with On- and Off-Exchange plans and enabling New Mexicans to compare all plans available in a market, demonstrates a model that could exist, even if the Affordable Care Act were to see major changes," said Franchini.
The plan comparison tool launches to the public on Thursday, October 26, 2017 at OSIcomparehealthplans.org. Additional information on consumer assistance departments within OSI may be found here. Additional information for in-person assistance from an agent, broker, or enrollment counselor may be found at beWellnm.com.
For more information on Consumers' Checkbook, visit Checkbook.org.