Technology

Health Insurance API v0.1


I started a new job about two months ago and I’ve been too
busy working like a beaver to write new posts. But enough
with the excuses.

The new job offers a HSA health insurance plan but my gut
feeling told me my wife and I would be better off with
another plan. Unfortunately, I was shocked to learn that
it’s so darn hard to compare health plans.

The two main problems are:

  1. Each plan is different enough so that direct comparison
    is tough.
  2. Even when plans are similar, it’s difficult to compare a
    list of rules and prices with another list of rules and
    prices.

Then I had the “Aha!” moment. What if I turned each health
plan into a single dollar amount?

Being a nerd, I whipped up some Java code that makes
comparison shopping easier. The main idea is that instead of
comparing premiums, deductibles, coinsurance, etc., you
compare a single dollar amount. You tell the library how
many times you expect to go the doctor, the ER, etc. and it
gives the estimated yearly cost (for a given premium,
deductible, coinsurance). Repeat this for different
scenarios, and voila, you know have a more concrete idea of
how much you can expect to pay.

The code is currently unusable unless you’re a programmer.
The next “Aha!” idea is to write a simple-to-use web
interface to use the health insurance library. I’ll my
progress on GitHub as soon as I get a chance.

The Results

After running the code on a few major health plans
(Blue-Cross, United, Humana), here’s what I found:

  • To compare health plans, think yearly, not
    monthly.
  • “Value” plans are poorly named. They’re for people who
    spend so much in doctors that they need a “value” plan,
    not for people who are broke.
  • Co-payment plans are good for people who are relatively
    healthy. (No major surgeries, no hospital stays, less
    than a dozen doctor visits.)
  • HSA plans are good for people with high health costs
    and/or families of three or more.
  • No matter how you slice it, health insurance is
    expensive. Be prepared to put at least $3K away each year
    plus your deductible.

So I ended up going with a co-payment plan. When my wife and
I decide to have kids, we’re switching to an HSA plan.