Here are few key pointers you should know about the health exchanges:
- The marketplace is open to all Americans, no one really has to use it to purchase insurance.
- “The 170.9 million people covered by employer insurance won’t need to use the marketplace. Although many employers will use the marketplace to purchase group health plans via a part of the marketplace called The SHOP or the Small Business Health Options Programs” (ObamaCareFacts).
- The exchanges provide a questionnaires to help you identify the types of insurance that best capture your needs.
- The exchange sites provide side-by-side cost and benefits comparison on different tiered plans.
- Health plans sold via the exchanges are distinguished into 4 health plan categories, also known as metallic levels—Bronze, Silver, Gold or Platinum. Each plan reflects different combinations of affordability and coverage.
- During open enrollment, you can go to the exchanges to enroll in a new plan, check for cost assistance, change plans, enroll in Medicaid or CHIP.
- Exchanges have people called the Navigators, whose job is to help shoppers through the whole process of buying health insurance, step-by-step.
- Cost assistance, including premium and out-of-pocket subsidies, is available through the exchange.
- By enrolling via the exchanges, you will be shown your savings from cost assistance (if applicable).
- All plans through the marketplace meets the minimum essential coverage standard set by ObamaCare.
- Open enrollment is the only time you can switch or buy new health plans. This may be different if you qualify for an exemption or experience a life altering event.
- Everyone, except those who qualify for Medicare, can use the marketplace to purchase insurance. Medicare isn’t part of the health exchange since they have their own enrollment system.
- If you missed the open enrollment deadline, don’t like your current plan, or currently don’t have insurance, you can still use the marketplace to explore your options. Applying doesn’t entail enrollment, you can simply browse around.
- Although anyone can use the marketplace, only people whose income is between 100% to 400% of the Federal Poverty Level (FPL) are eligible for cost assistance.
- If you make less than 133% of the Federal Poverty Level you will qualify for Medicaid if your state expanded Medicaid.
- As of March 2015, a Health & Human Service report stated that a total of 16.4 million Americans obtained coverage due to ObamaCare, whereas a separate RAND report stated that 22.8 million Americans obtained coverage while 5.9 million lost their plans, netting at 16.9 million newly insured.
- The exchanges are estimated to help 30 million Americans purchase insurance by 2020.
- There are 3 ways to apply for coverage via the exchanges: Online, In-Person, Phone, or Mail. Specific instructions on these methods can be found in healthcare.gov.
Where We Come In: Although the government health exchange is an important way to purchase health insurance, the process of buying insurance can be overwhelming for many. Studies show that consumers choose the wrong plan up to 88% of the time, costing them over $500 a year in unnecessary health expenses. Don't overpay or be overwhelmed when you shop for health insurance!
We at Take Command Health have developed a simple online survey that helps consumers find the top plans (on and off the exchange) at the most affordable rate. The survey is free and simple to use. You don’t have to be a health insurance aficionado to get the best deals, our powerful analytics platform will take care of that for you.
I wrote this blog to help people make smart health insurance decisions. I am a small business owner, a husband, and a dad to three boys, so I've seen firsthand how important understanding insurance decisions can be. As a co-founder of Take Command Health and a licensed health professional, I've been recognized as a leading expert on healthcare transparency and defined contribution arrangements (QSEHRA). I've been featured in the New York Times, Wall Street Journal, Dallas Morning News, Forbes and others. Learn more about me and connect with me on our about us page. Thanks!