Choose A Healthcare Exchange In Obamacare

How to Choose a Healthcare Exchange in Obamacare

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A major provision of the Affordable Care Act, also known as Obamacare, is the health insurance marketplace that will come into effect on January 1, 2014. Each state will set up a marketplace exchange where private insurance companies can offer people plans with different pricing and coverage levels. Between October 1, 2013 and March 1, 2014, people can apply to the exchange and choose private health insurance coverage.

Steps

Understanding the Healthcare Exchange

1. Read about the changes that have been and will be implemented through the Affordable Care Act by 2014.
   • The US Department of Health and Human Services has a graph depicting a timeline of changes. View it at http://www.hhs.gov/healthcare/facts/timeline/index.html.
2. Understand that many changes have already taken place to regulate private health insurance companies. The following are important changes.
   • Children can get coverage under their parents’ healthcare plan until the age of 26. Previously, healthcare coverage stopped at age 23.
   • Women cannot be charged more money for a healthcare premium than men. Before 2010, most females had higher rates than males.
   • The private insurance company must cover preventative appointments and some medications. A plan must include a single preventative wellness visit per year and certain necessary inoculations. The company must pay for the services, so that they are not charged to the insured’s deductible.
   • There are restrictions on denying coverage based on pre-existing conditions and raising healthcare premiums more than 10 percent.
3. Review the practices of private insurance companies. If you have never been insured as an adult, you should know what to expect when you look through plans in the health insurance marketplace.
   • Your plan will be paid for using a “premium.” This is a monthly payment that keeps your insurance active. A premium will go up depending upon the number of people who are covered under the plan.
   • Most health insurance companies provide several ways to pay for the premium. You can send a check, have an automatic withdrawal of funds from your account or pay for multiple months at a time.
   • In addition to the premium, each plan has a deductible. This is the amount of money that the insured person or family must pay before the health insurance company covers all or a higher percentage of all medical costs. For example, the deductible may be $3,000 for the year. Once you have incurred and paid for $3,000, your health insurance company takes on more financial responsibility.
   • The deductible resets each year on January 1, 2013.
   • A health insurance company may require you to use in-network providers. #*The percentage of the cost to you may change if you decide to use out-of-network doctors or facilities. The company should provide a list of in-network providers to you. Some plans have more freedom than others, so you can see whether your current doctor is considered in-network before you enroll.
   • Pay attention to the list of services that are covered with your plan. Hospitalization, dental, vision, specialists, addiction treatment, physical therapy and many other types of treatment should be considered, based on the percentage the health insurance company will cover.
   • These are just a few of the things to consider when choosing a plan. For instance, a plan with a higher deductible that has 100 percent coverage after the deductible is met may be a better financial decision if you foresee surgeries in your future.
4. Consider the Exchange a way to compare many plans at once. Before the Affordable Care Act, private individuals had to individually apply to each health insurance company to compare rates and coverage.
   • The application process used to include rigorous medical questions and interviews by each company.
   • The insurance marketplace simplifies the process. Now, you will fill out a single application that will be submitted to all participating health insurance companies.
   • You will be given different plans, premiums and deductibles so that you can choose the best and most affordable coverage in your area.

Finding Your State Marketplace

1. Go to Healthcare.gov. You will use this website to find your state’s marketplace. Approximately 26 states will have their marketplaces run through the federal government.
   • Other states opted to create state-run insurance marketplaces.
   • 7 states were given innovation grants for setting up state-specific exchanges.
2. Click on the “Get Insurance” tab at the top.
3. Choose your state name in the drop down list.
   • If your state is running their own exchange, you will be redirected to your state’s website.
   • If your state is using healthcare.gov to administer their exchange, you can sign up for an account through this site.
4. Sign up for an account. An account does not mean that you are required to use the exchange to find your healthcare plan.
5. Search for informational meetings about the Affordable Care Act.
   • Call your local hospital to inquire about informational meetings. Many hospitals are giving informational talks about the exchange between September 2013 and March of 2014.
   • Go to a meeting before October 1, 2013, if possible. This is when the open enrollment period will start. You have until March 2014 to join the exchange.
   • If you cannot find an informational meeting in your area, call the national hotline at 1-800-318-2596.
6. Set up an appointment with a local Affordable Care Act marketplace navigator or helper. People are being hired to meet with people and help them apply to the exchange.
   • You can find a navigator at your local hospital, state exchange website or through the national hotline.
   • If you feel like you need help filling out an application, this is the best option.

Applying for the Insurance Exchange

1. Go to your state exchange website or healthcare.gov on October 1, 2013.
2. Sign into your account.
3. Fill out the healthcare exchange application. You can fill it out yourself or get help from a Navigator.
   • You will need to disclose information about yourself and your health history.
4. Submit your application. Wait several days or weeks to hear your options from each company.
5. Take your time to choose a plan that fits you best.
   • Consider each of the people who will be insured in your plan.
   • Ask your friends and family who are insured if they will give recommendations of health insurance companies they use.
6. Choose your plan. You must enroll by March 1, 2014 in order to become insured this year.
   • Depending upon income levels, age and more, you may be eligible for Medicare, Medicaid or subsidized child healthcare. Sign up for these plans if you qualify, as they may be available at little to no cost.
   • People who choose not to be insured may face consequences. They may not receive tax credits to offset costs.
   • The Affordable Care Act states that each individual must be insured, and those who opt not to be insured will no longer receive free healthcare. If you cannot afford an insurance plan, you should inquire about qualifying for Medicaid or other subsidized plans.

Sources and Citations

• https://www.healthcare.gov/what-is-the-health-insurance-marketplace/
• http://www.getsmellout.com/how-to-get-weed-smell-out-of-house/
• http://www.whitehouse.gov/the-press-office/2012/06/28/fact-sheet-affordable-care-act-secure-health-coverage-middle-class
• http://www.commonwealthfund.org/Blog/2011/Jun/State-Health-Insurance-Exchange-Legislation.aspx
• http://guides.wsj.com/health/health-costs/how-to-buy-an-individual-health-insurance-plan/

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