Health Exchanges 2013: Looking Beyond the Basics

A lot has been said about how health insurance exchanges are now called marketplaces and how they are set to redefine the manner in which health insurance will be sold across the United States. However, it seems that the media is concerned about rotating the same piece of information repeatedly, not looking beyond the aspect of what different states are doing to meet the October 2013 deadline for creating a state exchange or defaulting to a federal exchange.

Using the Health Exchange Marketplaces
Whether it is the shop exchange or a state exchange, employers and individuals will have the liberty to browse, compare and seek more information about the different kind of health plans on offer. For seeking information, online and physical entities can be approached depending upon how the exchange is being managed by the state authorities. Some of the states are in the process of creating physical offices and smaller regional connecting points of contact where health care enrollment information will be provided in the physical format, including forms and printed applications.

The other, easier approach is to seek the information on the web or the phone. In fact, health care enrollment might be confirmed to a large extent on the phone itself provided the person can provide accurate, necessary details. People will have free access to outreach professionals like navigators and assistors who will specialize in providing information about different plans or providing answers to typical questions like how to provide Medicare application for Medicare part B or Part C.

ACA and HRAs
During the first phase of the health care reforms a phase-in period is being offered. This refers to the run-up to October 2013 when the health care exchanges will come into existence. This phase is of particular importance for adhering to health care rules such as removing annual or lifetime limits on health plans. One such application of the phased rulings is found in the case of HRAs that are offered by employers to employees. HRAs are an intrinsic part of employee benefits management. However, the HRA has an annual limit that is in direct opposition of the ACA mandates. However, if the HRA is combined with another employee coverage, as a part of a group insurance plan, where the annual limit is raised progressively and then set to no-limits in January 2014, the HRA is allowed for a waiver.

First Phase of Health Exchange Coverage
During the first few months of its functioning, the health exchanges will be primarily devoted to offering insurance to people who have been traditionally uninsured and those who don’t qualify for insurance despite the presence of highly-discounted health insurance programs like Medicare, Medicaid and CHIP. These numbers are expected in millions and will include many of the high-risk individuals who have typically been denied coverage or are faced with reduced coverage due to the extremely high amount of medical services expenditure they incur.