What the Heck is a Health Insurance Exchange?

health-insurance-shopping-cartThis is the second installment of a month-long series on how the Affordable Care Act, commonly known as Obamacare, benefits women and what you need to know if you do not have your insurance or lose your insurance to get coverage through it.  Check back each Wednesday in June for a new post – and let us know in the comments if you have questions or have already benefitted from Obamacare.

Soon being female will no longer be considered a pre-existing condition.

Many health insurance companies charge a woman more than a man for the same coverage – often significantly more. A 2012 report by the National Women’s Law Center found that this practice of “gender rating” costs women approximately a billion dollars a year.

Starting in 2014, gender rating will be illegal, thanks to the Affordable Care Act (ACA).

The ACA will also prohibit insurance companies from discriminating against you because of a pre-existing condition. In 2014, companies will no longer be able to deny you coverage, charge you exorbitant rates, or limit your benefits because you have heart disease, cancer, asthma, high blood pressure, arthritis, or two X chromosomes.

One of the biggest provisions of the ACA kicks in next year – the establishment of health insurance exchanges (also called marketplaces) for the purchase of individual insurance. If you get insurance through an employer or through a family member’s employer, this change probably won’t affect you. But if you have to buy insurance on the individual market, this is going to be a really big deal.

Right now, buying insurance on the open market is kind of like buying a car – if the car was sold in tiny pieces and you had to determine whether all the pieces you needed were included in the price. Is this gauge really necessary? Can the car run without that screw?

It would be difficult to compare the cost of one car to another in a system like this. And that’s what buying health insurance is like right now. Trying to figure out what’s covered, what’s not, and how much you’ll have to pay if you get really sick is nearly impossible.

The health insurance marketplace will change that. It will be easier to compare different health plans, so you know what you’re getting and how much it will cost you. It’s an online system, and using one application, you can find out what plans are available and compare them easily.

Healthcare.gov has lots of information about the ACA and includes a cheesy animated video (at least the government isn’t wasting money on production values) explaining how the marketplace will work.

According to the video:

It’s a place to compare a wide range of quality health insurance plans, to review them all side by side, and choose the one that’s right for you. You’ll find the information clear and easy to understand. You’ll explore the marketplace at your own pace. You can compare prices and benefits, see an explanation of what a premium is and what a plan will cost you every month – before you make a choice.

All of the plans will have to cover essential health benefits. That includes emergency services, maternity care, mental health and substance abuse services, and preventive and wellness services.

The ACA includes tax credits for families and for small businesses to help them cover the cost of insurance. The idea is that for everyone, insurance will be affordable.

Each state is supposed to set up its own health insurance marketplace, but North Carolina lawmakers chose not to. So instead, North Carolinians will be able to buy insurance on an exchange set up by the federal government. Open enrollment begins this October.

And in January, thousands of people in North Carolina will have access to something they’ve never had before – affordable health coverage.




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