Moms

Healthcare website has answers for consumers

Confused about the new healthcare law?

A new online tool, www.HealthCare.gov, might help.

The website, launched last week, provides some of the answers to how the federal Patient Protection and Affordable Care Act, enacted in March, affects you.

Such information could provide a welcome guidepost to uninsured Texans, who account for about 25 percent of the state's residents.

"You can ask very tailored questions in the website's prompts that provide you the latest information and options," said Stacey Pogue, senior policy analyst for the Austin-based Center for Public Policy Priorities, which describes itself as a nonpartisan advocate for low- and moderate-income Texans. "All of these pieces of healthcare -- COBRA, dependent care, Medicaid, etc. -- are finally put together to make a map of the different places people can find healthcare."

The one-stop tool helps simplify a complex issue that confounds most Americans. In a poll by the Kaiser Family Foundation, 55 percent of those surveyed said they were confused about the law and 56 percent said they didn't have enough information to understand how it will affect them personally.

HealthCare.gov, developed by the Health and Human Services Department, provides detailed information on insurance options based on a short list of questions regarding your age, medical condition and whether you have been denied coverage, are uninsured or can't afford insurance. No name, address or other identifying information is required.

Once you enter your information, the website lists options. Among them: individual insurance plans available in your area; information on Medicaid (the state-federal health program for the poor), Medicare and other federal healthcare programs; details on a new high-risk insurance pool available to those with pre-existing conditions; and a list of free or low-cost healthcare facilities near you.

Starting Thursday, consumers will be able to view premiums for the new Pre-Existing Condition Insurance Plan, or PCIP. Rates are expected to be significantly lower than those of the state's existing high-risk pool.

The federal plan was created under the healthcare overhaul and is designed for those who have pre-existing conditions, have been uninsured for at least six months and have been denied coverage in the regular insurance market. The plan is a stopgap until 2014, when insurers will no longer be able to deny coverage of adults with pre-existing conditions. (This happens for children beginning in September.)

In October, insurance companies must post on the website their premiums for regular health plans. Already available on the website, under the list of policies available, are what drugs and medical services are covered, the provider network and contact information.

The Texas Department of Insurance worked closely with the federal agency to provide data and a cross-check of policies available in the state, said John Greeley, department spokesman. "We've been working intensely with HHS on coding and providing data," he said.

HealthCare.gov often directs Texans to the department's own consumer-friendly website, www.TexasHealthOptions.com. That website provides options for the uninsured, from college students and parents to seniors and people with disabilities.

Since the site was launched in fall 2005, it has received 1.3 million hits and is steadily growing in popularity, Greeley said.

"We saw a big jump from 240,000 in 2008 to 700,000 in 2009," he said.

Still, that number has to increase quite a bit to catch up with the 6.1 million Texans without insurance.

HealthCare.gov also offers information on programs that are often hard to find, said Pogue of the Center for Public Policy Priorities. For example, there is a program under Medicaid designed for women with breast or cervical cancer. It provides care for uninsured women at higher income levels than typical Medicaid coverage allows.

The website also discusses implementation of the Affordable Care Act, teaches about prevention and offers a link to quality rankings for healthcare providers and preventive services.

"People need to see what choices are offered, what options cost and how coverage works in practice," Karen Pollitz of the federal agency's Office of Consumer Information and Insurance Oversight said in a statement when the website was launched.

She called HealthCare.gov "an important first step in that direction. In the coming months and years, we will add pricing and plan performance information so that consumers can see and understand and make meaningful choices about their health coverage."

Next week, I'll compare pricing and coverage of the new Pre-Existing Condition Insurance Plan with the Texas Health Insurance Pool.

Teresa M cUsic's column appears Fridays.

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