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Health Care Exchanges

Buying it might be easier and cheaper with the new health care exchanges.

Imagine shopping for health insurance the way you shop for clothes at the mall. You could see your choices, get answers to your questions, and select the health plan that fits you and your budget best.

That’s what you’ll get when you shop for health insurance on a health care exchange.

Established through the Affordable Care Act, exchanges are state-based* marketplaces designed to make it easier for people to purchase health insurance. Small employers will be able to go through exchanges to offer insurance to their employees as well.

Simplifying your choice

When health care reform takes full effect in January 2014, most people will be required to carry health insurance. That means if you don’t currently have health coverage, you’ll have to get it or risk being fined.

Health care exchanges bring together information about all of your health insurance options in one online location. They allow you to compare your choices, learn if you’re eligible for public health insurance programs or tax credits that will make coverage more affordable, and join the plan of your choosing.

You can enroll in an exchange starting in October 2013.

How they can help

According to the U.S. Department of Health and Human Services, exchanges will perform a number of valuable functions. For instance, they will:

• Certify that a health plan provides key benefits, follows established limits concerning deductibles and co-pays, and meets other requirements.

• Provide information on all of the plans offered in a standardized format.

• Assign ratings to each plan based on quality and price.

• Operate a website and toll-free phone number where you can get information on the plans and purchase them if you qualify.

A good buy

Having health insurance is a tremendous benefit. But finding the right plan takes time. Exchanges will help make the process easier. And that may make good health easier to achieve and maintain.

You can learn more about exchanges and health care reform at www.healthcare.gov.

Learn more about how Centegra Health System can keep you well at www.centegra.org.

*Some states have elected not to set up an exchange. In those states, the federal government will operate the exchange.

 

5 Questions to Ask When Shopping for a Health Plan

Good health may be the most important thing anyone can possess. Good health insurance can play an important role in helping you achieve it.

When selecting a health plan, there’s a lot to consider. Cost is certainly one factor but it shouldn’t be the only one. It’s to your advantage to find coverage that meets your needs, values your preferences and demonstrates its worth.

Here’s a checklist of questions to ask yourself as you weigh your options:

Am I clear about what the plan will cover? Look for specific details about coverage for doctor visits, hospital care, prescription drugs, and dental and eye care. It’s good to look into coverage for home care, nursing home care and services like physical therapy too. You might not need these today, but you could in the future.

Can I keep my current doctor, hospital and pharmacy? Be aware that with some plans, your choices are limited. What’s more, you may not think these choices are high-quality options.

How did previous coverage fit my needs? Often, it’s helpful to take a closer look at the kinds of claims you’ve had in the past and weigh them against the coverage a new plan will offer.

What’s the most I’ll have to pay out of pocket? Premiums are only one consideration. It’s important to consider other factors such as deductibles and co-payments as well.

If there’s a dispute about a bill or service, how will it be handled? Sometimes third parties have a role. It’s a good idea to learn how problems will be addressed up front.

Sources: Agency for Healthcare Research and Quality; USA.gov