However, I also find it misleading. As someone who has been through the process of buying private insurance before: there are a number of sites like this (though none of them as elegant and spare). All of them will give you comparative rate charts. But those rates don't mean anything.
After you select a provider, you have to fill out their application, which is onerous. They then do whatever record pulling they do in their backend and come back to you with an answer, which you can expect to take the form of "we can insure two of you for $JACKED_RATE, and we can't insure the other two at all", at which point you get to spend weeks in their appeals process figuring out which 15 minute doctor visit from 4 years ago put your wife or daughter on a "do-not-cover" list.
I'm not just complaining about the (horrible) US insurance system here. I'm saying that sites like this don't work. No web developer has access to the real information this app purports to have, which is "what can I expect to pay for coverage from providers in my area".
Note also that there are plenty of agents who will do this kind of legwork for you; they're often compensated by affiliate fees from insurers.
(For what it's worth, the identical problem exists with comparative car insurance shopping; you can get rate charts all over the Internet, but it's not until you fill out the application for a specific provider and wait a week that you'll find out how much higher your rate is than the advertised minimum.)
What would be very valuable would be a crowdsourced version of these charts.
In my case, the hardest part was trying to compare plans from the companies in my area. All of them have slightly different ways of making it profitable for them. One could have Rx copays, but a special deductible for ER and urgent care visits. Another company may have only Rx reimbursement and office visit copays. So on and so forth. I actually had a spreadsheet with about a dozen columns to try to figure out, based on how I've used healthcare in the last few years, what plan is likely to be best for me.
Anything to simplify it would be great.
Moreover, the companies I've worked with on this, Blue Cross of Florida and United Healthcare (GoldenRule), in my own experience, the rates they quoted me online after filling out their survey were correct.
Healthcare costs and complexity surely go up as we all get older, so that, plus difference in state laws, probably explain the differences in value we see in this app.
Did you fill out complete applications for Blue Cross and United? Were you presented with a sign-on-the-dotted-line contract with a rate on it?
Were you applying solely for yourself?
Again, if you're in your 20s, healthy, male, and alone, you are very easy to insure, because you cost epsilon for Blue Cross to insure.
I think your point is correct that the site is a (now cliched?) "leaky abstraction." But the good news is that it works for at least some segment of the market (those like myself).
I was 25 when I did the Blue Cross app and 27 when I did United.
Starting in 2014 individuals can buy insurance directly in an Affordable Insurance Exchange. An Exchange is intended to be a transparent and competitive insurance marketplace where individuals and small businesses can directly buy qualified health benefit plans.
It doesn't solve the immediate problem obviously, but the Federal timeline for implementation is here: http://www.healthcare.gov/law/timeline/index.html
Individual states are free to set up exchanges prior to the mandatory deadline, but with politics being what they are, that's not a guarantee of swift action. The details on implementation will be promulgated by Health and Human Services, most likely via the CFR and Federal Register, so we don't yet know how it will shake out in detail. But there's an overview PR-style here:
Could not agree more with your post, and the item quoted above in particular.
(My own case: I'm as healthy as an ox, wife has inflammatory arthritis, which makes the application look like a book. When everything is done, you can be sure that we end up paying $JACKED_RATE*$MYSTERY_FACTOR.)
You can also expect that any woman with any reproductive health issue, no matter how common, will be automatically declined for private health insurance, and will at best be able to obtain outrageously expensive last-resort insurance with a rider excluding huge swaths of her physiology.
But these sound like simple gripes about how broken our insurance system is. That's not my point. My point is that the rates you get on a website like this have no bearing on the rates you'll actually be contractually promised, unless you are a healthy male in your 20s.
I wonder if advertised rates like this are somehow based on average group coverage rates. It's completely whack, but, none of this stuff applies in group coverage. In group, you tell your provider "here's how many families, couples, and singles we have", and I think maybe the ages, and then you get a simple number for each category.
That said: If you have a startup paying you regularly, I believe there are non-exclusionary laws preventing the insurance company from excluding employees which makes it a good avenue to pursue. I know folks that structured buyouts so that they would continued to be employed (and paid) by a shell company simply to maintain insurance.
Not so fast. If she never goes "bare", she can't be denied for pre-existing conditions.
Is it really that hard for people who know that they have chronic conditions to act as if they have chronic conditions?
I'm not going to get into the severity of the "chronic conditions" we're talking about because they're none of your business, but based on prevalence in the population, it's crazy that they're auto-decline conditions.
> based on prevalence in the population, it's crazy that they're auto-decline conditions.
Are they "auto-decline" or "they can't charge expected costs"?
> I'm not going to get into the severity of the "chronic conditions" we're talking about because they're none of your business
No one asked you to, so why the attitude?
One major insurer that I'm familiar with receives applications from the biggest of these sites by fax, on paper. They're then shipped to a low cost country, where they're scanned, and then passed along to another low cost country to have the OCR corrected. Then the work comes back on-shore to be manually adjudicated. Figure 3 days minimum, a week on average to get all of this done.
A crowd-sourced solution would be astronomically useful. For it to be accurate, you need to capture a decent amount of medical information (most insurers ask a pretty standard set of ~20 questions), but even knowing that the average person pays 1.4x the quoted rate for someone of their age/gender/zip would be a great tool.
Of course, they can still mess with you and they won't hesitate to do so if they think they can't make money at this price. There's no way to find out the final rate without completing the entire application process. In that respect it's similar to auto insurance.
PickHealthInsurance still has a lot of utility compared to existing sites, though.
You can get often get the advertised rates, but not always. In Washington State for example, you can get these rates if you're running out of COBRA and you've been covered continuously. They aren't allowed to ask questions.
I don't think there's a magic bullet, unfortunately. Suggestions welcome.
Even with the SHQ, it seems deterministic.
Another leg work item is understanding the plan details. While it is great to see initial set of plans, it is hard to compare plans (how does United Health "Saver 80" compare to the IHC Group "Freedom HDHP"?). Possible feature enhancement: provide me a table compare of the details.
Lastly, many of the details of picking a plan for families centers around the current health ecosystem: Is our pediatrician participating in the plan, what is really covered, and what is the track record of the insurance company paying claims. That deeper information, if offered early, could help in the search for a plan.
Why shouldn't I, and many other people, open our medical records and insurance information? I.e. post it to some publicly accessible database, anonymously or not.
Could we get insurance providers to make us individuals/families offers, then, instead of us having to do the searching?
It may take some time before such a social/industrial shift occurs, if ever.
In the meantime, a bot that submits my info to various providers and gives me their actual quotes in sortable format could expedite choosing health care based on actual quotes, rather than the (usu. equal or lower) advertised rates.
I put this together over a few weekends. My COBRA is about to run out and I found it exceptionally difficult to compare plans and prices with the existing sites. This is the third time I've had to buy individual insurance and I finally decided to do something about it.
Things crystallized for me when I almost bought a plan that claimed to cover maternity, only to discover late in the game that it had a separate $20,000 maternity deductible! What a mess!
I have a few goals with PickHealthInsurance:
- start showing approximate rates almost immediately, don't pester me with a bunch of questions
- explain confusing terms like "coinsurance" and point out the difference between a PPO and a POS.
- show plan stats up front, not buried deep within the bowels of the application process
- make it easy to use and blazingly fast
- Rails 3.1 (HAML, Sass, Coffeescript)
- Twitter Bootstrap CSS
- Deployed on Heroku/MongoHQ
What do you think?
I'd love to be able to specify the number of children I'd be putting on my plan (maybe not on that first page, but on an internal "refine" page?).
Also, it'd be great to have checkboxes allowing me to select two or three plans, to then compare them head-to-head.
But, again, this is an excellent first version. I look forward to seeing where it goes.
Also, I really like that it's fast. Don't lose that part. :-)
It also highlights the near complete lack of correlation between how much a plan costs and how much benefits you get.
My startup, Bloom Health (http://gobloomhealth.com) is in a similar space, but where you're going directly to consumer's who are shopping for their own health insurance (B2C), we're a B2B2C model, we work with employers and provide health insurance choices to their employees.
We work within the employer system by changing from the existing defined benefit health insurance model (where employees get health insurance as a benefit for working for their employer) to a defined contribution model (where employees get a set amount of pre-tax money from their employer to spend however they want, including health/dental/HSA/etc.
The site was built by HHS, which had access to information provided by the insurance companies themselves on their acceptance rates, etc. I'm not sure why the insurance companies agreed to provide that sort of information, nor whether that information was made available to the public at large.
Idea: Perhaps add columns so you can sort plans by co-pay for Doctor visits, ER visits, an prescriptions? Maybe hide those columns by default so the GUI doesn't get too cluttered, but let users display them if desired.
Your core problem is going to be that approximate rates are based on answers to questions. The fewer questions you answer the less accurate your rate will be. Go talk to a few agents and let them draw out the benefits for you, they are free to you and they exist for this very purpose!
If you could parlay some deals with the insurance companies related to being an "authorized reseller" where you could input Medical History and come out with a Comparative List that you could sign up for.... you'd be sitting pretty. IMO.
BTW: Twitter Bootstrap looks like a great base template. I'm surprised I have never seen it before.
I have the same question as other people - how are you pulling this data?
One thing you definitely need on the front page is gender selection. Gender instantly changes the price of insurance significantly and is a simple binary question.
I hate dealing with health insurance so much so I very much hope this site evolves and becomes a success for you. Well done.
Edit: Now you need to monetize this. The obvious way to do that is to do lead gen if they offer it.
A "total annual cost" column would be helpful for making sense of the deductible/premium/co-pay relationship. Think of it as the "Price+Shipping+Tax" on shopping websites.
Ask the user how much he expects his doctors to charge him ("Annual Medical Bill") in the next twelve months, then calculate how much he would pay to the doctors and to the insurance company. Last time I bought health insurance I had to make a spreadsheet to calculate this. I would rather not repeat that mundane task again.
It might also be useful to have multiple predefined Annual Med Bills ($0, $1,000, $5,000, $20,000, etc). Displaying the output on a graph might make sense (AnnMedBill vs TotalAnnCost, with a curve for each plan). You should customize these to the user's age (a 23 year old may not go to the doctor for years at a time, but even a healthy 50yo will definitely go several times per year for checkups and *oscopies).
Mapping costs to life events (no doctor visits, a few visits, broken arm, healthy pregnancy, etc) would make it even more useful, but researching the necessary assumptions will take considerable work so just implement predefined dollar amounts as a version 1.
Keep up the good work, this idea has value!
It was just too complicated, though. Most people don't even understand what "coinsurance" is. I might add some pretty calculators later if the site gets some traffic.
That's exactly why you should add a calculator, so people can see how the variables interact.
How did you get all the insurance rates and terms, just from the companies' sites?
When I tried evaluating the health care plans my company offered me a few month ago I had a terribly hard time getting information about the different plans that are out there. (But then again, I'm not from the US and the whole health care system keeps confusing me.)
The one thing that would have made things a lot easier for me is being able to sort by out-of-pocket maximum. I wanted a high-deductible, HSA-compatible plan, and so having a low out of pocket maximum was my number one criteria.
I wonder how many people actually know what they want in a health insurance plan? There are a huge number of options, and it's hard to know what's important. The guidance I found on the web tended to be generic, rather than targeted at the type of plan I wanted (major medical).
Perhaps you could outline a few broad plan types, explain the advantages, and allow users to pick one?
For example, I would have picked a "major medical plan", and it would have shown me plans that have solid out-of-pocket maximums that aren't much higher than the deductible. The data displayed for each plan would highlight differences between those plans (e.g. HSA-eligible) that might not be so important to a another plan type (e.g. full service plans).
How do you generate your rates? Your math seems dangerously wrong in a lot of places, especially when requesting family rates.
(This is verifiable by running a rate on this website, and then going to one of the carriers websites and generating the same quote)
Disclaimer: I work in the health insurance industry, so many of these rates were obviously wrong as soon as I saw them.
Recommendation: Get your employer to build this and not the stuff that's on most health insurance sites. Note especially that you don't have to enter your name or email to get a rate and plan information. Kudos to you if your company has already done this!
On general note, this site really emphasizes how fucked up is health system in US. There is complete lack of correlation how much a plan costs and how much benefits you get.
There should be version: WhyHealthInsuranceinUSSucks.com
I'm notoriously cheap, but would happily shell out a commission or even a one time fee for the service — keep it this simple and straightforward and you'll not only have a compelling business but a tool that really helps people.
I ended up with 79 plans and that is a bit much to sort through. Perhaps you could have a slider on the results that let you manually set the minimum deductible.
Also I assume the charge listed was monthly but you didn't state that.
If I had launched such a nice service I would try to charge the end user. I would be willing to pay money to an independent third party.
I hate it because the industry is years behind. 90% of our clients demand IE6 support because their companies still use them. We constantly have to integrate with legacy systems and people don't understand how to consume our web services. It's very stable, but boring.... It's a bad place.
Nice to see competent tech people getting into the market. I wouldn't mind starting/joining a health startup but I signed a pretty damning non-compete.
What was the reasoning behind that? Are there other options that aren't mutually exclusive that sometimes show up dynamically? Was it a visual choice?
The checkboxes underneath act like checkboxes.
If it's a visual choice, why not use some actual style?
http://jqueryui.com/themeroller/ (see "buttons")
Maybe a next step would be for users to be able to save their plan name/type and then they can come back for comparisons. If you do that they maybe allow people to opt in for emails if a similar plan comes up as their saved plan but has a lower cost. Keep up the good work.
As a Canadian, I'm bewildered that this has to even exist.
Where are all my local companies? Where's BlueCross BlueShield?
PickHealthInsurance looks nice and clean. Good job!
There's another site that I've seen that does something similar: http://www.prodigyhealthinsurance.com/
just become broker yourself and keep the leads, then pass them off to the Insurance company with leveraged commissions.
Very cool site.
I put in some details from when I was living in the US and I'm shocked—I can't find a plan that isn't 50% copay on brand name drugs?
- side-by-side comparison (check several, show all)
- easy print-out of plans and side-by-sides, or PDF-gen
- tool-tips for filters at left. nice tool-tips on terms in rows already
- filter by deductible, co-pay, premium amnts (eg <$500)?