Common Questions about Health Insurance Exchanges, Answered
Health insurance Exchanges are set to redefine the healthcare landscape of America. Once the Exchanges are established, people will have access to a consumer conscious, more accessible and price sensitive health insurance market.
However, there are some confusions regarding how the Exchanges will function. Some people are worried about specific aspects of health Exchanges such as how will Medicare application work in a health Exchange or how Exchanges will affect employee benefit management. This article provides easy answers to some questions. Just read through and understand how health Exchanges are set to alter the health insurance buying experience forever.
Are health Exchanges the result of some rule or law?Yes, in March 2010, President Barack Obama signed the PPACA or the ACA or federal health care rule into a law. Since then, the healthcare reforms have been steadily spreading across the nation. 2013 is a landmark year as it will witness the creation of state health Exchanges across the nation. Some states might be slower in their efforts to establish the Exchanges but eventually, all states will have to abide by the law. Due to this law, many landmark changes have taken place. For instance, lifetime dollar limits on health plans have been removed and insurers can no longer say “No” to you on the basis of a pre-existing health condition.
How many types of health insurance Exchanges are expected?There is some confusion in this matter but largely, three to four types of health insurance marketplaces or Exchanges will be seen. This includes the state Exchanges, the state-federal Exchanges and the federal Exchanges. Besides these, some of the states might collaborate to create regional Exchanges. Within a state, many smaller Exchanges can also exist. These are being called subsidiary Exchanges at the moment. Besides these basic types of Exchanges, you should also be aware about specialist Exchanges that will be found within the parent, state or federal Exchanges. For instance, Shop Exchange or the Small Business Health Options Program will be found for smaller employers, i.e. those employing less than 50 people. Private insurance firms are redesigning their portals, making them very similar to state Exchanges. These can be understood as Private Exchanges.
How will the health care insurance Exchanges work?Basically, each Exchange is essentially an online marketplace designed to function like an online travel deals site. The idea is to provide consumers the freedom to browse, select, compare and buy health insurance in the most informed manner. For this purpose, Exchanges are likely to have many automated functions such as an insurance quote engine or a Medicare quote engine where based upon the basic details provided by you, your Medicare coverage or premium liability would be calculated within seconds. For better employee benefit management, employers are like to shop for group health insurance plans on the Shop Exchange.
How will I gain information about the workings of an Exchange?This will be possible via a variety of options including a navigator program and assisters. These entities could be individuals or public bodies who would be enrolled to provide accurate information about different types of plans, Medicare eligibility enrollment, Medicaid or CHIP coverage, tax credits, subsidies and Exchange eligibility for individuals. The role of navigators and assisters is to bring-in the traditionally uninsured populations within the ambit of health insurance.
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ABOUT THE AUTHOR
Author is an expert in the emerging U.S. exchange marketplace, systematically following trends emerging from the niche of private exchanges health care and Exchange Connectivity.