Open Enrollment Begins, Kinks in the Cost Calculator Tool on Healthcare.gov and Other OE News

By Sandy Ahn, Sabrina Corlette and JoAnn Volk

Open Enrollment 3 (OE3) is now underway, and by most accounts, it’s going pretty smoothly. In the first two days operation, federal officials estimate that consumers have submitted approximately 250,000 applications.

We have, however, received feedback from Navigators about a few kinks in the out-of-pocket cost calculator available on healthcare.gov. Site operators have already fixed some of these; others are still being worked on. The cost calculator is a tool consumers can use when browsing available health plans. The cost calculator is designed to provide an estimate of an individual or family’s annual total out-of-pocket costs depending on their projected health care use. Our own work with navigators and numerous studies show that consumers tend to focus on premiums when choosing a plan and don’t consider or even understand how other costs like deductibles and co-pays add up when obtaining care. This tool will help consumers see what the total out-of-pocket cost may be, depending on their anticipated level of health care use.

Federal officials are also working to deploy two additional tools for consumers – a “Doctor Lookup” and a “Prescription Drug Check” feature. Both are still being beta tested, but federal officials are making the “Doctor Lookup” feature available to randomly selected users as part of its phased-in approach to ensure accuracy. According to federal officials, the provider tool will be available to one in four visitors on healthcare.gov and users will have to opt-in to use the tool. Users can also leave comments about their experience with the tool directly on the website. While healthcare.gov has access to over 90 percent of insurer data about providers, some provider data is still missing or inaccurate. Under this scenario, the provider tool will inform the user that “no data from insurance company” exists when searching for a particular provider. The “Prescription Drug Check” will also be piloted as well in the coming weeks.

Administration officials hope to have both tools available to all consumers before the end of open enrollment. Consumers will be able to use these tools to identify which plans include their doctors and prescription drugs in their networks and formularies. Once live, the tools could really help streamline consumers’ shopping experience. Press accounts suggest federal officials are working with insurers to verify that the data they send to healthcare.gov for the doctor and prescription drug look-up feature is accurate – a necessary step to ensure these new tools are helpful and not misleading for consumers.

For more on changes to healthcare.gov this OE3, check out Tricia Brook’s blog post here. As OE3 unfolds, CHIR will continue to keep you up to date on what’s working – and what’s not – for consumers as they navigate the enrollment and plan selection process.

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The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.