New Support Features on HealthCare.gov

WASHINGTON, D.C. (December 15, 2015)—As consumers count down to the December 15 enrollment deadline for January 1 coverage, the Centers for Medicare & Medicaid Services (CMS) announced today that new HealthCare.gov consumer decision support features piloted earlier this enrollment season will now be fully deployed to all visitors. The new Out of Pocket Cost calculator, Doctor and Facility Lookup and Prescription Drug Lookup features will help consumers to more easily search for the plan that best meets their budget and health needs.

“We are constantly focused on improving the consumer experience,” said Kevin Counihan, CEO of the Health Insurance Marketplace. “Over the past month, we have tested and improved these new decision support features on HealthCare.gov to help consumers pick the plan that best meets their needs. Listening to consumers has always been our top priority and this year we heard their call for additional resources to help them search for and identify the best plan for their families. All consumers visiting HealthCare.gov to search for coverage ahead of the December 15 enrollment deadline will be provided with relevant, personalized and more up-to-date information about their plan options before enrolling.”

Based on consumer feedback about the information they want to help pick the right health plan, a number of new features have been developed for HealthCare.gov. Since November 1, a new Out of Pocket Cost calculator has helped consumers better estimate the cost of their health insurance based on their personal situations. The feature provides consumers with an estimate of what their premiums, deductibles and co-pays may be, based on their own anticipated health care service utilization, for each specific plan. Understanding total out of pocket costs for any given coverage option is essential for consumers to select the most affordable plan. Consumers can get this information before they select a plan.

Since Open Enrollment began on November 1, two additional features were piloted: the new Doctor and Facility Lookup and the Prescription Drug Lookup, which provide consumers with easily searchable information about a plan’s network of doctors and the prescription drugs plans may cover as consumers shop and enroll in coverage. Both tools were initially piloted—reaching about 1 in 4 visitors to HealthCare.gov—and selected at random, which allowed developers to examine the consumer experience with the feature and analyze the quality of the data based on consumer feedback.

Since the features launched, approximately 2 million visitors to HealthCare.gov chose to search for their doctor and prescriptions drugs when shopping for coverage through the Marketplace. The Doctor and Facility Lookup feature and the Prescription Drug Lookup feature are now fully deployed and available to all consumers searching for plans on HealthCare.gov.

This year is the first time insurers are required to provide up-to-date information about which doctors and facilities are in their networks. Plans must also provide access to information on what medications are covered in the health plan formulary. HealthCare.gov has access to data from more than 90 percent of insurance companies on the Marketplace. If an insurance company has not provided validated data, consumers will be alerted when they search for a provider that there is “no data from insurance company.” CMS will continue to provide technical assistance to insurance companies that have not yet provided access to their data and will update HealthCare.gov on a daily basis.

Consumers are reminded that health plans can change which doctors and facilities are in their networks on a continual basis, and providers can change locations and affiliations. For these reasons, we are encouraging consumers to check with their doctor or plan to confirm that their doctor accepts that plan. Consumers will be asked to opt-in to use the tool to be sure they understand limitations with the data and will be able to leave comments and suggestions for improvement directly through the site.

Open Enrollment for 2016 health coverage at HealthCare.gov began November 1 and runs through January 31, 2016. Individuals who want health coverage starting January 1, 2016, must sign up by the December 15 deadline. Consumers should visit HealthCare.gov or CuidadodeSalud.gov to review their coverage options, learn about what financial assistance is available or to sign up or re-enroll in a plan. You can also call (800) 318-2596 for confidential assistance 24/7.