What You Need to Know: A Virtual Tour of the Health Insurance Marketplace

| December 6, 2013

ID-10029020 (1)The marketplace is open. Now what? You need health insurance – the government is mandating it. But, you don’t know what to do. More than that, you’re not sure you can even afford it. What happens when Jan 1 rolls around and you don’t have a policy? Don’t let that happen. Hop on the exchange, and try to get all of that taken care of ASAP.

The State Exchanges

State exchanges are one of the first places you’ll want to go. Check to see if your state has set up an exchange of deferred this responsibility to the federal government. Not all states have their own exchange. The plans, premiums, and policy details will all be the same, regardless of where you go or where you buy them from.

Companies like MediGapAdvisors.com are also out there to help you navigate the exchanges if you’re at or nearing retirement and need help with Medicare supplemental insurance.

The Federal Exchange

The federal marketplace is a central repository for all of the nation’s health insurance plans. Essentially, all plans in the marketplace will be standardized and will provide minimum coverages and coverage levels based on the plan you choose. All insurance is offered by private insurance companies, but they cover the same set of core benefits called “essential health benefits.”

No plan can turn you away because of a pre-existing condition or current illness. They must cover and treat those conditions. Plans also cannot charge women more than men for having the same plan. Additionally, many preventative services are covered at no cost to you.

Plans In The Marketplace

The plans in the marketplace are divided up into five major categories: bronze, silver, gold, platinum, and catastrophic. In general, policies with lower premiums have higher out of pocket costs. Plans with higher premiums have lower out of pocket costs. So, for example, a bronze plan will likely cost you very little, but you’ll pay a higher share of costs when you need health care services.

Platinum plans, on the other hand, have the highest monthly premium but the lowest out of pocket costs  for medical care. The plan will pay more of the costs if you need care compared to the bronze plan. Catastrophic plans are generally reserved for those individuals who are under the age of 30.

Searching For Coverage

To search for coverage, you’ll need to fill out a few forms online, disclose some personal information, and then search for the plans. You’ll be able to search according to which types of plans you think will be most suitable for you. Just sign up at healthcare.gov and then go through the process of creating an account.

Once you’re done creating an account, and you’ve found your plan, you simply sign up and pay the premium. The insurer will send you an insurance binder – proof of coverage. Then, you will receive your actual policy and details about how to use your new health insurance plan.

Susan Thomson studies the healthcare market. She often blogs about the causes and effects of market changes.



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Category: Health, Medical Insurance

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