I would love the knowledge and insights of Mefites on this decision and on my top three contenders for insurance companies and their networks:
Oscar and Health Republic are both new and there doesn't seem to be a ton of info available on them. But I would love anything that you all know or have reason to suspect about them, as well as any personal experience or reviews that you might have of Metroplus.
Any feedback about the doctors and hospitals on the Metroplus network or the Magnacare network, which both Health Republic and Oscar seem to use, would also be great.
I like the connectivity that Oscar seems to promise, organized electronic records, free telephone medical care, and some free primary care. I don't love that the founders seem to be Ivy league tech startup golden boys but don't want to hold it against them too much. I don't like that their plans seem consistently more expensive. I like that you don't need referrals to specialists.
I like the coop-ness of Health Republic, though don't love the expenditure that their advertising blitz seems to represent. I like the free access to a PCP with their PrimarySelect plans, though not sure they're a better value than the EssentialCare plans (unless maybe for the acupuncture?). I like not needing a referral to specialists. I like that they are the cheapest bronze plan for me.
I like the not-for-profit-ness of MetroPlus and the fact that they're more established. I really really like that they have by far the cheapest gold and platinum plans for me. I really don't like that you need referrals to specialists but think I could live with it.
As far as price shopping, this is the spreadsheet
that I made to try to compare the plans available to me (in Brooklyn, as a thirty-something). For now, at least, I'm not eligible for subsidies and/but even the relatively more expensive platinum plans would represent a much better deal than the insurance I have now. I'm completely on the fence about which to get - I'm generally pretty healthy. On the other hand if I had access to reasonably priced health care I might use a lot more of it, especially potentially therapy and mental health care. While I've had bare bones insurance, my entire health care has been 1-3 trips to the urgent care clinic for urgently needed (generic) antibiotics.
Part of me wants to get the cheapest bronze and hope for the best, part of me wants to get a platinum and never argue with myself again about whether a health need is really worth spending the money on. On the spectrum I guess I am relatively risk-averse.
All of me is comforted by the fact with a best case absolutely no health care needs year I 'waste' maximum (of the choices I am looking at) about $3000 on the 'wrong' more expensive premium plan, and with a worst case scenario health year, I 'waste' maximum about $3500 on the 'wrong' cheaper premium plan. For now at least that is margin of error I can live with, and though my job is very unstable, I know that if I did lose it I would be eligible to change plans as well.
(All of me is also sad that my gynecologist is only in network for the ridiculously priced United plans which I can't even begin to consider as a realistic option.)
Please, what do you know about these companies? About their networks? How are you thinking through the risk calculations and cost calculations for yourself? How do you think I should think about it for me? Am I missing anything?