Health Insurance: Open Enrollment 2006

When it comes to health care, it pays to be informed. So, read on for help in making sense of your options.

DIY: Online Tools Can Help Identify the Best Plan
Insurance Sites' Pros, Cons | Health Site Test Drive
Info for Federal Workers | Sites to Learn More

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Sites for More Eyes

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Pro: Kaiser's Interactive Health Plan Advisory prompts prospective and current enrollees with basic demographic, health-status and cost-preference questions that generate the type of plan -- HMO, PPO, CDHP, etc. -- best suited to the individual.

Con: Overall lack of pricing and quality tools.

What's ahead: Kaiser aims to unveil a tool this month to provide members with the cost of physician and some inpatient hospital services in metropolitan Washington. Kaiser also plans to provide its members with links to the National Committee for Quality Assurance and several other outside organizations that examine the quality of health plans, hospitals and doctors.

UnitedHealthcare

Members of UnitedHealthcare plans can sniff out deals at http://https://www.myuhc.com . Enrollees can estimate the cost of medical treatments, picking from 80 common hospital procedures and many other specialty procedures, with pricing based on Zip code.

Take shoulder surgery: The tool will break down the costs -- including anesthesia, surgery, radiology, professional and facility fees -- related to the procedure, contrasting in-network and out-of-network prices. The member can also see expected out-of-pocket costs.

Providers are awarded one or two stars for quality -- or none at all. (A zero-star listing indicates that the provider does not meet the voluntary standards set by his or her specialty society.) The hospital rating tool uses a three-star rating system, and members can drill down to look at the hospital's death and complication rates on specific procedures.

The pharmacy savings advisor allows a member whose information is already in the system to order drugs and show how much can be saved by choosing generics or ordering by mail.

A plan cost estimator allows people to key in demographic and health information -- to find which health benefit suits them best.

Pro: Cost estimates give a decent perspective about overall costs of treatment. Most tools are easy to use, and many can be tailored to a particular member.

Con: United's physician quality rating scheme tells little more than whether the specialist meets the parameters set by his or her respective medical society. A test drive of the plan cost estimator tool shut down a reporter's computer initially.

What's ahead: Next year, United plans to launch an integrated health card, which will contain key aspects of an individual's medical record. The wallet card can be swiped in a reader at a doctor's office to provide key medical information.

Medicare

Since the late 1990s, the Medicare program has been the trend-setter in providing consumers -- in some cases even those who are not Medicare beneficiaries -- with pricing and quality information in an easy-to-use format. Consumers can get information on nursing homes, home health providers, hospitals and dialysis facilities. More recently, the site ( http://www.medicare.gov/ ) has been carrying powerful pricing data, particularly on prescription drug costs.


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