2 Myths about Health Care Exchanges Busted

By October 2013, states need to have their own Exchanges or a collaborative effort in the form of a state-federal Exchange or default towards a Federal Exchange. Payers are refurbishing their work processes to ensure that their workflows are in accordance with the mandates of the ACA. However, keeping the people abreast with the changes that are being brought about with the health care reforms, particularly about the Exchanges seems to have taken a backseat. We seek to address this issue by busting some of the most common misbeliefs about the Exchanges:

Buying Insurance from the Exchanges is MandatoryNo, purchasing health insurance from the state or federal Exchanges is not mandatory. As long as you have some form of health insurance, you are not forced into buying any kind of health insurance or getting yourself associated with a health insurance marketplace. You can also purchase your insurance outside the realm of state or federal exchanges. For instance, you can try the private exchanges that seek to offer a streamlined and simpler way of purchasing health insurance, just like the state or federal health exchanges. Some of the features of the private health exchanges too are most likely to be similar to state or federal health exchanges. This includes the presence of automated functions like having an insurance quote engine or a Medicare quote engine.

State or Federal Exchanges Might Make Buying Insurance a Lengthier ProcessThe facts are just the opposite. The health insurance marketplace has been conceived in such a manner that purchasing insurance becomes faster, more transparent and easier. This includes the mandates for many consumer focused tools like the SBC or the summary of benefits and coverage. It is imperative that at the time of enrollment of a new subscriber, the insurance firm listed at the exchange provides a SBC that fully explains every aspect about the coverage, specifically any limits with regards to any medical condition and what the coverage cannot include.

Secondly, information submitted once by an applicant will be used optimally to reduce the processing time. For instance, at the time of Medicare application, the information will be processed via tools similar to a Medicare quote engine and all the details for buying Medicare primary and supplementary plans and coverage benefits will be provided. In a similar fashion, once an application is received, the exchanges will coordinate with the CMS offices to ensure that cost sharing as a part of Medicaid or CHIP is calculated for the applicant.

It is better to keep yourself updated about the healthcare reforms and the exchange marketplace by seeking free memberships to some of the more credible resources that are governed by state or government authorities or by subscribing to Google Alerts. You can also log on to the blog section of information sources like hCentive that provides up-to-date information in this niche.