Most of the insurance company “making up” is being done through policy redesign. Buyers of the exchange policies will discover one or more of the following “feature modifications”:
1. The doctors and hospitals available for exchange policy holders will be a sub-set of those available on the same coverage purchased through an employer.
2. The deductable will be increased by as much as four times.
3. Copays will be increased.
4. Coverage for services provided by doctors outside the group will be eliminated.
5. The reimbursement rate will be reduced from a typical 80 % to 60 or 70%, with 80% coverage limited to the “premium” policies.
6. Guidelines for permitted care will be tightened.
7. And, of course, premiums will be increased.