Starting October 1, healthcare consumers (aka you and me) can start shopping and enrolling for health insurance. This is a pretty big shift from the current methods in which we seek out insurance. Currently, there are three basic options for health insurance:
- You may have your health insurance provided by your (or a family member's) employer. Typically, the decision that needs to be made for this type of health insurance is to select one of several plans by the same insurance provider, depending on what type of coverage you are looking for.
- An alternative, is that your (or a family member's) employer may not provide health insurance, the insurance provided may be too expensive, or you may be unemployed and not qualified for assistance (e.g., Medicaid or Medicare). At this point, you may be looking for low-cost health insurance. In order to do so, individuals typically have to seek out several companies on their own, and it may be a long and difficult process to determine what policy would be available and reasonable for you (and your family).
- Other individuals may elect not to receive/purchase health insurance at all.
You may be wondering how the Health Insurance Marketplace will change these three basic options.
- This option will remain the same. One or more health insurance options may still be provided by your (or your family's) employer.
- This option will contain the largest change. If you are looking for a low-cost insurance option for you and/or your family, you can now use an online Health Insurance Marketplace to seek out affordable, available insurance. Some of the biggest changes are in the ways that insurance companies offer health insurance. For example, an individual can't be rejected from receiving health insurance or being renewed on a plan simply for having a previously existing condition. Also, the rate you pay for health insurance is only based on your family size, the area where you live, your age, and tobacco use. Other factors, including gender and pre-existing health conditions, can no longer be used to determine your rate.
- This option may have a smaller change associated with it. While still not purchasing health insurance is an option, there may be a fee you have to pay. This fee, known as the individual shared responsibility payment, depends on your income, family size, and the year in which you are paying the fee. Information about the fee and exemptions can be found here.
It may seem like there are a lot of changes happening in regard to health insurance. While this is certainly true, and there is a lot of information out there to read and understand, there are many resources available to help us understand the Health Insurance Marketplace. Check out some of the resources below:
- Official website of the Health Insurance Marketplace (Centers for Medicare and Medicaid Services - CMS)
- Healthcare.gov (CMS)
- Healthcare.gov - FAQ (CMS)
- Health Insurance (USA.gov)
- Find Local Help - Including through the use of Navigators (CMS)
- Learn about the new Missouri Health Insurance Marketplace (Cover Missouri)
- Video: Health Insurance Changes Coming Your Way Under the Affordable Care Act (Kaiser Family Foundation)
- Press Release: New resources available to help consumers navigate the Health Insurance Marketplace (CMS)
- People with Medicare and the Health Insurance Marketplace: FAQs (CMS)
- Video: Ready, Get Set, Enroll! (Catholic Health Association)
- Arthritis specific online toolkit and checklist (Arthritis Foundation)
- 24 hour toll-free, consumer assistance number: 1-800-318-2596 (TTY/TDD: 1-855-889-4325)
In order to enroll for health insurance beginning January 1, 2014, you must enroll between October 1 and December 15, 2013. Are there specific questions you have about the Health Insurance Marketplace or the changes through the Affordable Care Act? If so, please post in the comments or email us at firstname.lastname@example.org.