Webinar OE6: Plan Selection Strategies
The Right Fit: Helping Consumers Navigate the Plan Selection Process
In a special Health Reform: Beyond the Basics webinar presented by Dave Chandrasekaran, a training consultant and certified application counselor, on September 25, 2018, Part IV provides an in-depth lesson on effective strategies to support consumers with understanding how commercial insurance works, evaluating and comparing Marketplace plans, and selecting the plan that best meets their families’ needs.
This is Part IV in a 4-part series on core elements of eligibility and enrollment.
Presentation Slides
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Overview of What’s Covered
Overview of Marketplace Plans
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Overview of cost sharing
- Explaining cost-sharing terms
- First dollar coverage
- No cost sharing for preventive services
- Negotiated rates for services
Overview of covered benefits
- Other covered services
- Prescription drugs cost sharing and formularies
Provider networks
- Types of provider networks
- Searching for a provider
Trends in Marketplace Plans
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Partial exemptions from the deductible
Deductible-only plans
Additional prescription drug tiers
Narrow and/or tiered provider networks
- Inaccurate provider directories
Strategies to Help Consumers
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Preparing for open enrollment
- Tracking changes in the lowest-cost plan options
- Comparing differences in provider networks
- Studying all plans in your area
Tailoring search based on consumer needs
- Renewal or new applicant?
- Prescription drugs or current doctors?
- Major health needs or anticipated procedures?
- Finding options for first dollar coverage
Understanding consumer tradeoffs
- Bronze vs. silver plans
- Paying more to preserve access to providers or prescriptions
- Bronze plan + community-based coverage or other alternate sources of care
- Benefits of coverage vs. going uninsured
Live Plan Selection Demonstration via Healthcare.gov
Please note that this section of the webinar features a live web-browsing demonstration that is not reflected in the static slides.
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Scenario 1: General plan comparison (single adult)
Scenario 2: Weighing in-network doctors and current prescriptions (married couple)
Scenario 3: Comparing out-of-pocket costs (family of three)
Q&A
Additional Resources
Resources | View resources links
Worksheet: Marketplace Plan Comparison Worksheet
Webinar OE6: Plan Design
Key Facts:
Beyond the Basics Webinar Series | View all webinars
Key Facts About Health Reform | View all key facts
Tools and Resources | View all tools and resources
Frequently Asked Questions | View FAQs
