Health insurance sold on the exchange is an important part of the Affordable Care Act, also known as Obamacare. The law allows Americans to buy insurance if they don’t have coverage through their jobs. Insurers sell plans on the exchange that comply with minimum standards set by the law. Plans on the exchange can be sold by private companies, non-profit organizations or public agencies. Most plans have four levels of coverage — bronze, silver, gold and platinum — that represent how much you’ll pay out of pocket for your health care costs
In this post, we find out What Is The Official Term For Health Insurance Sold On The Exchange, state exchanges vs federal exchanges, what is an insurance exchange, and affordable care act insurance exchange.
What Is The Official Term For Health Insurance Sold On The Exchange
An exchange is a marketplace where consumers can shop for and compare healthcare plans. The exchanges are an important part of the Affordable Care Act, also known as Obamacare, which allows Americans to buy insurance if they don’t have coverage through their jobs.
An exchange is a marketplace where consumers can shop for and compare healthcare plans. The exchanges are an important part of the Affordable Care Act, also known as Obamacare, which allows Americans to buy insurance if they don’t have coverage through their jobs.
There are two types of exchanges: those run by individual states and those run by the federal government. The state-run exchanges were intended to create competition between insurers in order to reduce costs for consumers; however, some critics argue that many state-run marketplaces have low enrollment numbers due to high premiums or limited plan offerings.
Obtaining insurance through the exchange is a process that requires some research, but it ultimately gives people more options when it comes to buying health care.
To buy health insurance through the exchange, you must:
- Be a resident of the state where you are purchasing your insurance. If you are not a resident, you will be able to purchase insurance on your own or through an employer in your home state. You should check with them first before applying for coverage on the exchange because they may offer other options that they think would work better for your needs.
- Have a valid Social Security number (SSN). A SSN is required before submitting an application for coverage at any time during enrollment period (October 1st through December 15th). If someone does not have an SSN yet but needs one for their job, it can be obtained after submitting an application for coverage by using Form SS-5 from Social Security Administration’s website; once this form has been completed and submitted back into SSA system along with documentation proving citizenship/legal status in US – then new card will be mailed within 10 days after return receipt date stamped by courier service both times they were delivered to correct address provided during application process took place successfully without encountering any issues whatsoever. It could take longer if there wasn’t enough space left over after initial card sent out due demand exceeded expectations since demand was so high due popularity among eligible persons looking forward receiving benefits offered under Affordable Care Act program created back during Obama administration era.”
All US states now have exchanges that are either run by the state itself or in partnership with the federal government. There are also exchanges specifically for small business owners.
The term “exchange” refers to the marketplace where consumers can shop for and compare health insurance plans. Consumers can buy insurance if they do not have coverage through their jobs or a government program like Medicaid.
The Affordable Care Act created exchanges in every US state, but since then, some states have chosen not to run their own exchange and instead use HealthCare.gov. All US states now have exchanges that are either run by the state itself or in partnership with the federal government (called a “partnership”). There are also exchanges specifically for small business owners (called Small Business Health Options Program, or SHOP), which are only available in certain states at this time (those with an asterisk next to them).
Insurers sell health plans on the exchange that comply with minimum standards set by the law. Plans on the exchange can be sold by private companies, non-profit organizations or public agencies.
As the law was written, insurers are required to offer a minimum level of coverage. Plans on the exchange can be sold by private companies, non-profit organizations or public agencies. You must have health insurance or pay a fine if you don’t get it through an employer or other source by Jan. 1. Plans purchased on or off the exchanges also must meet certain standards, but may have different benefits than plans sold on them.
Most plans have four different levels of coverage — bronze, silver, gold and platinum — that represent how much you’ll pay out of pocket for your health care costs.
Most plans have four different levels of coverage — bronze, silver, gold and platinum — that represent how much you’ll pay out of pocket for your health care costs. Bronze plans have lower premiums but higher deductibles, while platinum plans have the highest premiums but lowest deductibles. The higher the level, the more you pay for premiums and the less you pay for health care costs.
Insurance bought through an exchange is subject to certain rules and requirements so consumers know what they’re getting.
Insurance bought through an exchange is subject to certain rules and requirements so consumers know what they’re getting. These include sharing information about the cost and quality of health plans, as well as providing a list of all doctors who accept each plan.
There are also limits on how much insurers can charge in premiums based on age, gender and geographic area. In addition, insurance plans available through an exchange must cover 10 essential health benefits that include prescription drugs, maternity care and mental health care.
Consumers with pre-existing conditions can’t be denied coverage or charged more for their insurance than other people with similar medical histories or risk factors within their state’s community rating system (see above).
state exchanges vs federal exchanges
Are you looking for health insurance coverage for yourself and your family? Or are you a small business owner looking for affordable health insurance for yourself and your employees? If you’ve answered, “Yes” to either of these questions, then you might have heard of state-based health insurance. A federal or state exchange plan for insurance isn’t just about picking an individual or family health insurance plan. These exchanges are often the only way for many people to receive healthcare insurance based on their income or lack of it.
So how do state based plans work, are they federally subsidized, and how do you purchase them? Here’s what you need to know about state-based health insurance.
What is a health insurance exchange?
So, what is a state exchange plan? The health insurance exchange or marketplace is a centralized portal where people can compare and shop for health insurance coverage. Some states have their own marketplace platforms and fully run them. Other states use the federally run platforms. These portals give you access to health insurance plans of all types from a variety of insurers.
Who can use the health insurance exchange?
The Health Insurance Marketplace created by the Affordable Care Act is open to all United States citizens and other legal residents of the country. Two major exceptions include incarcerated individuals and people with Medicare. Some small businesses can also use the Marketplace to shop for health insurance and supplemental insurance coverage.
Sometimes, you may need to supplement the Marketplace insurance with other forms of coverage for specific needs.
What is a state exchange plan?
State-based health insurance is sold via state health insurance exchanges. A state-based health insurance exchange is an insurance marketplace where the state provides the infrastructure, the website, and the customer support for individuals and small businesses to purchase state based plans.
When the Affordable Care Act was signed into law by President Obama in 2010, states were allowed to choose whether to establish their own state-based health insurance exchanges or not. Some states already had their own state-based health insurance exchanges, so they could decide if they wanted to continue operating. In states that chose to not form their own health insurance exchanges and offer state based plans, individuals can obtain insurance through the federal exchange. There are also other options for buying health insurance on the individual market, such as getting a plan directly through the insurance company, or buying from a private broker like eHealth, where you’ll get to see hundreds of plans from various companies.
Every state has major medical plans that are not sold on the state-exchange, so make sure to check out this type of “state-based” health insurance when shopping online. States that offer their own health insurance are allowed to determine which insurers can offer state based plans via their exchanges.
In some states, all insurers can participate. In others, they have to meet certain coverage or rate requirements. In yet others, the states give priority to insurers whose plans offer benefits that align with the state’s overall health needs. For example, if a state has a high rate of obesity, it might select insurers that offer coverage focused on obesity treatments.
There’s actually no such thing as state-based health insurance
If you hear someone reference state-based insurance, what they’re likely referencing is a health insurance plan that is regulated by the department of insurance in that state.That doesn’t mean that you can only use the insurance in that state, and it doesn’t mean you have to buy it on the state’s exchange. It simply means it was approved as an insurance product in that state, for that state’s residents. You can’t buy it, if you live in another state.To really understand health insurance you first have to understand that there are a number of different types of coverage you can buy.
Major Medical
The first is major medical health insurance. Major medical health insurance is usually the most comprehensive coverage you can buy, and it’s also typically the most expensive. Every major medical health insurance plan offered in a state has been approved by that state’s department of insurance (with a few minor exceptions). That means, if you don’t live in that state, you can’t enroll in that plan.There are three distinct features of major medical health insurance:
Short-Term Medical
Short-term medical insurance exists to fill in the gap when you’re waiting for open enrollment periods or waiting for your coverage to begin. If there’s any amount of time when you don’t have insurance but expect to have healthcare insurance again soon, then short-term medical insurance will cover you in the interim.
Indemnity Medical
Indemnity medical insurance or fee-for-service healthcare plans will pay a flat fee for your healthcare services. If that fee doesn’t cover the amount of the service, you will have to pay the remainder out of pocket. Some forms of these plans count as major medical health insurance, but not always.
These types of plans can also work as a supplement to your regular health insurance, especially when used for a specific purpose. However, an indemnity healthcare plan isn’t compliant with the ACA. You will receive none of the benefits associated with using the government exchanges.
States with their own state-based health insurance marketplaces
So exactly how many states run their own health insurance exchange?
Currently, there are 15 states with their own marketplaces. Some of these marketplaces offer plans for individuals, as well as for small business owners and employees. Others have marketplaces that are only for owners and employees of small businesses. In these states, individuals can’t purchase state-based health insurance and are instead are required to go to Healthcare.gov. But in every state, people still have the choice to buy on private marketplaces, such as brokers like eHealth, or straight from a health insurance company. Below are the states with their own state-based insurance marketplaces:
How federal subsidies work with state based plans
While many people believe that state based plans are only available for people with low incomes, the truth is that they actually benefit a large portion of the middle class. The reason for this is that federal subsidies on state-based health insurance plans apply for people within certain income brackets. If you earn between 133 percent and 400 percent of the federal poverty level, then you qualify for federally supported state-based health insurance. That means that your monthly premiums for your state based health insurance plan will be lower depending on how much subsidy you qualify for.
In 2017, the federal poverty guidelines were as follows:
Federal subsidies on state-based health insurance are frequently referred to as “tax credits” because they’re automatically added to your tax refund. However, they’re applied at the beginning of the tax period to lower the premiums on your state based plan based on your estimated income for the year. If you earn more or less than what you estimated, your subsidy is adjusted accordingly when you file your tax return.
Be careful about guessing your income when applying for health insurance. If you are estimating your income and guess low in order to get a larger tax credit, you’ll likely end up owing money once tax season comes around.
How do you buy health insurance on state-based health insurance exchanges?
If you want to purchase insurance on a state-based health insurance exchange, the process is relatively simple. When you go to the relevant state-based health insurance website, you’ll be asked to enter some person information to determine whether you qualify for a federally supported state-based health insurance plan. (Note: You can also go to Healthcare.gov, which will redirect you to your state’s marketplace.)If you qualify, you’ll be presented with the health insurance plans you qualify for. You’ll see that the plans are divided into four categories. These categories represent how you and the insurer will divide medical costs:
Of course, the right category for you will depend on your own specific needs. You’ll be able to review the health insurance plans and what specific coverage options they offer before selecting one. And don’t worry if you find it confusing: Most marketplaces provide additional phone support in case you need extra assistance understanding the various options.
Benefits of buying insurance through the health insurance exchange
Because the plans in the Marketplace must meet the criteria set by the ACA, there are several things that come along with them as standard, such as the essential health benefits.
All plans have some free services, such as preventive care. Many will offer additional benefits like discounts on prescriptions and other health-related programs. A prime example of this is the plethora of women’s preventive care services available.
When you purchase insurance through the health insurance exchange, it’s also possible to find an excellent healthcare insurance provider with quite a few added coverage options. This can include things that you simply won’t see with some non-ACA providers, such as a larger focus on mental health and some alternative medicine practices.
what is an insurance exchange
A health insurance exchange is an online marketplace where consumers can compare and buy individual health insurance plans.
The number of private exchanges – established by benefit companies and health insurance carriers – has grown in recent years. However, the exchanges you’re hearing about are most likely the state health insurance exchanges that were established as part of the Affordable Care Act (ACA) – that’s what’s described here.
State health insurance exchanges are a platform that allows individuals and small businesses to compare numerous health insurance plans side-by-side, and purchase the coverage that best fits their needs.
Under the ACA, all individual and small-group plans must conform to the same regulations, regardless of whether they’re sold through the exchange or off-exchange. All individual and small-group plans effective January 2014 or later must cover ten essential health benefits including emergency services, hospitalization, preventive services and more; these requirements apply both on and off the exchange.
But consumers are only eligible to receive premium subsidies and cost-sharing reductions if they purchase their coverage through the exchange.
Open enrollment periods are the same on or off the exchange, and you can’t switch from having an off-exchange plan to having an on-exchange plan outside of open enrollment, unless you have a qualifying event.
As of 2020, there are 38 states that use HealthCare.gov as their exchange portal; the remaining 12 states and DC have their own state-run exchanges and enrollment systems. Five of the states that use HealthCare.gov are considered state-based exchanges, but use the federal platform for enrollment (Arkansas, Kentucky, New Jersey, Pennsylvania, Oregon, and New Mexico).
Pennsylvania and New Jersey, both of which use HealthCare.gov in 2020, plan to operate their own state-run health insurance exchanges starting in the fall of 2020. So residents in those states will enroll in 2021 coverage using the state-run platforms.