What Will Be Covered by Insurance Marketplace (Exchange) Plans?

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Insurance plans will be designed for more comprehensive consumer comparisons

 

Insurance plans in the Marketplace are offered by private companies. They cover the same core set of benefits called Essential Health Benefits. No plan can turn you away or charge you more because you have an illness or medical condition. They must cover treatments for these conditions. Insurance plans must offer unlimited dollar amounts for the lifetime of the insured to cover the 10 Essential Health Benefits. Plans can’t charge women more than men for the same plan. Many preventative services are covered at no cost to you.

 

The Insurance Marketplace is also called the Exchange. Consumers who purchase Exchange plans may be eligible for advance tax credits to help pay premiums if they qualify, but the plans do not have to be purchased through the government website to receive these subsidies. You can use the services of an independent agent to help you navigate these choices and choose the best options for you at no additional cost.

 Some additonal features of Exchange plans:

  • Choosing a doctor: You can choose any available primary care provider in your insurance plan’s network. You can choose any available network pediatrician as your child’s primary care doctor.
  • No referrals needed for OB-GYN services: You don’t need to get a referral from a primary care provider before you can get obstetrical or gynecological (OB-GYN) care from a specialist.
  • Access to out-of-network emergency room services: Insurance plans can’t require higher copayments or coinsurance if you get emergency care from an out-of-network hospital. They also can’t require you to get prior approval before getting emergency room services from a provider or hospital outside your plan’s network.

 

 Enrollment in the Insurance Marketplace begins October 1, 2013 and ends March 31, 2014. CSR and Associates The Benefits Group offers on-site enrollment for employees and groups, and partners with community centers and businesses to educate and enroll individuals, families and employees in the Insurance Marketplace.

 

Patient Protection & Affordable Care Act (PPACA) information discussed in communications is most accurate as of this date. The Department of Health & Human Services may amend or change federal regulations at any time.

 

2013-09-02T02:58:21+00:00 September 2nd, 2013|Categories: Exchange, Individual Insurance, Recent News|0 Comments