For the second time in my life, I'm uninsured. I'm also without a job and, as I browse the health insurance marketplace, I'm increasingly frustrated with my options. There are four types of plans available to me (I was not eligible for Platinum coverage). 1. Catastrophic (pays for nothing until you reach the deductible) 2. Bronze (pays 60% of costs) 3. Silver (pays 70% of costs) 4. Gold (pays 80 % of costs)
To paint a picture of the options I'm looking at, I made a handy chart (click to enlarge). I was presented with 25 total health plan options, and I selected five of them to illustrate the cost and coverage differences. I also included numbers from my previous employer-provided plan, which expired back in August.
As you can see, my employer coverage was fantastic. I realize that costs were probably subsidized in some way, but as far as my wallet is concerned, I payed only $134.38/month for anxiety-free, full coverage health insurance.
On to the health care marketplace plans. The costs don't seem that terrible at first glance, but really consider who the buyers are and what kind of circumstances they're in. They're likely:
1. People who've lost their jobs. 2. People who work part-time jobs and aren't offered health insurance by their employers. 3. Poor people who aren't poor enough to qualify for Medicaid.
Catastrophic vs. Bronze vs. Silver vs. Gold
On the surface, catastrophic insurance looks like a pretty good deal. You're in good health and your life is relatively risk-free. You can go to the doctor, but -- uh oh -- if you need a prescription or a specialist, you're out of luck. (What's the point of going to the doctor if you can't get a prescription anyway?) On top of the $1k you pay for premiums, you better be ready to pay the $6500 because absolutely nothing is covered before that.
Again, if you're in a position where you're forced to buy catastrophic insurance, can you even hypothetically afford $7500 in medical bills?
Also notice the difference between the cheapest and most expensive catastrophic insurance offered to me. The benefits are identical, aside from the $20 vs. $40 copay for a Primary Physician, yet the more expensive plan costs $500 more a year. Does this microscopic increase in benefits justify the increase in premiums? I saw this again and again as I tried to find the right plan for me.
As I looked at Bronze, Silver and Gold plans, I noticed the premiums increased significantly while the cost of services generally stayed the same. Not one plan offered to me covered X-rays/diagnostics until after the deductible was met. The deductible did decrease as plans got more expensive, but as a relatively healthy person with very little income at present, the monthly cost seems to exceed the benefit.
Healthcare.gov Is Not That Bad
Yes, it's a failure of a government website. BUT, for all the complaints about healthcare.gov, it's easy once it works. When I signed up for health insurance after college (because, in 2009, the economy was crap and I couldn't find a full-time job), I had to enter my medical history for the past FIVE YEARS. It asked me for all my past doctors and doctors appointments; what medications I'd taken; any emergency room visits. It was hell. Not only did I not have access to all that information, I felt like the insurance company would find me out and reject my application if I wasn't thorough.
Healthcare.gov asked me for barely any information at all. My address, my income and if I was a smoker. Simple. Easy. Fast. I was approved! I moved on to Step 2. And, after much comparison, step 2 is where I stay for now, in hopes that I ultimately won't need to sign up at all.