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Renewal time - and now the fine print

Big Changes in Fine Print of Some 2015 Obamacare Plans

By Charles Ornstein, Lena Groeger and Ryann Grochowski Jones
ProPublica, December 4, 2014

Millions of people nationwide bought health insurance this year through the federal government's health insurance exchange, often through the website Healthcare.gov. Now, as they pick plans for next year, they face a complex battery of choices and changes.

They have until Dec. 15 to select a new plan or they'll be re-enrolled automatically in the one they currently have. Or, if that plan no longer exists, they'll be enrolled in another product offered by the same insurer, when available. But even if they get the same plan — of the nearly 2,800 health plans offered in 2014, about 1,700 of them will exist in the same form next year — their benefits may not stay the same.

Much attention has focused on changes to plans' monthly premiums, but changes to other kinds of benefits — affecting the cost of things like doctors' visits and prescriptions — can be trickier to understand and make a huge difference in annual health care costs.

Some policy changes appear subtle, just a matter of adding or subtracting a few words, but are actually quite significant. This year, many insurers charged members a set fee of a few hundred dollars for emergency room visits. For next year, some of those plans changed the wording of their benefit, adding "co-pay after deductible." That means the insurers won't pay for any portion of an emergency room visit until consumers meet their deductible, spending thousands of dollars.

What ProPublica's analysis suggests is that even those who would be willing to pay higher premiums to keep their current plan may be surprised to learn that substantial details have changed. They should go back to Heatlhcare.gov or to ProPublica's news app to make sure their plan is still the best choice.

Changes to insurance benefits are hardly exclusive to the Affordable Care Act marketplaces. They happen regularly in health plans offered by employers.

http://www.propublica.org/article/big-changes-in-fine-print-of-some-2015...

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Comment:

By Don McCanne, MD

Will everyone who is surprised that the the private insurers are changing the fine print on the plans offered through the exchanges please raise your hands. (Sorry, I can’t see your hands, just as most of those purchasing plans on the exchanges won’t see the fine print either.)