What Is It?
You may have heard it called the Health Insurance Exchange, the Health Insurance Marketplace, or the Healthcare Exchange. Don’t let all the names confuse you because they refer to the SAME thing (for your information, the official name is the Health Insurance Marketplace). According to Wikipedia, Healthcare Exchanges are “organizations set up to facilitate the purchase of health insurance in every state of the United States in accordance with the Patient Protection and Affordable Care Act (Obamacare). Marketplaces provide a set of government-regulated and standardized health care plans from which individuals may purchase health insurance eligible for federal subsidies.” Basically, the Healthcare Exchange is an online website where consumers can go to view and purchase all the new Affordable Care Act (Obamacare) compliant healthcare plans available in their state.
What Do You Need To Know About It?
• If you do not currently have health insurance, federal law requires you to obtain it or be charged a fine of $95 or 1% of your income, whichever is larger, on your 2014 tax return. There is one exception: if insurance will cost more than 8% of your income, you’re exempt from the fine.
• Plans became available for purchase on October 1, 2013 and coverage will begin January 1, 2014, according to federal law.
• Anyone can use the Healthcare Exchange tool, but it is specifically for individuals who do not currently have insurance or are unhappy with their current coverage.
• You can compare all available plans side-by-side.
• You can search plans based on personal factors like income, family size, etc.
• No plan can turn consumers away or charge more because of an existing illness or medical condition.
• Men and women receive the same price for the same plan, no exceptions.
• The marketplace is run by your state or federal government, not a private company.
• It is intended to be easy. Easy to understand and easy to find a plan that fits your needs and budget.
• Plans are categorized into four different groups: bronze, silver, gold, and platinum. Bronze being the cheapest and platinum being the most expensive.
• If you purchase a plan at the marketplace, your price will be locked in for 2014. Your insurer can increase premiums the following year, but you can also shop around for a new plan.
Want To Know More?
To find out more about the Healthcare Exchange and to shop for plans specific to Colorado, call us here at Rocky Mountain Health Brokers at 303-523-7650 or check out the resources available to you on our website including information about The Affordable Care Act and Obamacare.read more
At one point or another, everyone finds themselves in a situation that necessitates the use of the American healthcare system. For a lot of us, our lives begin and end in a hospital. In order to protect ourselves financially, we purchase health insurance. Have you ever looked into the laws that govern our health insurance system? Maybe you have, now that ObamaCare is the talk of the nation. Even if you have been researching insurance laws, it’s likely that most people don’t spend their free time reading up on it. It’s unfortunate, but we will all get sick or injured at some point. We end up spending a lot of time and money on healthcare. So doesn’t it seem important to be familiar with the laws that govern health insurance? For your convenience, the following paragraphs contain brief explanations of a few of the most important health insurance laws in Colorado that may be important for you to know.
For the Consumer
Health Insurance Portability and Accountability Act or HIPAA. HIPAA has a lot of different facets. It…
- Limits insurers’ power to deny/delay claims.
- Minimizes your chances of losing your coverage.
- Makes it safer and easier for you to change health plans.
- Prohibits discrimination based on health problems.
- Protects patients’ privacy if they are over 18—other than you and your health care providers, no one can gain access to your health care records unless you have expressly given your consent.
Other health insurance laws for the consumer include…
- Coloradans are guaranteed renewable insurance plans, meaning your insurer can’t cancel your coverage if you get sick or injured.
- Consolidated Omnibus Budget Reconciliation Act or COBRA. COBRA guarantees continuation of group coverage from a former employer for up to 18 months.
For the Insurer
All Colorado insurance plans are required to provide coverage for certain services including:
- Breast and prostate cancer screenings
- Treatment for certain diabetes-related conditions
- Children’s vaccinations
The Affordable Care Act (Obamacare) requires insurers to…
- Allow children to stay on their parents’ insurance until they are 26.
- End the practice of denying coverage based on pre-existing health conditions.
- Publicly justify their actions if they want to raise their rates by more than 10%.
- Discontinue placing lifetime dollar limits on plans.
- Cover preventive services with no deductible or co-pay.
- Spend at least 80 cents of your dollar on health care and improvements to health care—not administrative costs—or give you a refund.
Other health insurance laws for the isurer include…
- Insurers maximums for physical and mental health conditions must be the same.
- Individual insurance plans must include maternity coverage.
These are just a few of the most important health insurance laws in Colorado. If you would like more information on these and other laws visit www.colorado.gov, www.healthcare.gov, and www.hhs.gov. Be informed about the health insurance laws that affect you. Knowing the laws helps you better understand how your health insurance works and what you can expect from your policy. You may also contact us, Rocky Mountain Health Brokers, at either 303-523-7650 or email us here. We’d be glad to answer all your health insurance questions!