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A Guide to the Health Insurance Exchanges

Under the Affordable Care Act, many health reforms were put in place. Among these, the ACA required states to set up health insurance exchanges, but what exactly are these exchanges? How can you use them?

What Are The Health Insurance Exchanges?

Health insurance exchanges are marketplaces that are operated by each individual state, the federal government, or by a combination effort. Each state has its own individual exchange. In each exchange, residents who do not have employer-provided health insurance or government-sponsored health insurance, such as Medicare or Medicaid, can purchase their own insurance plans. Each state has its own specific website where consumers will enter certain personal information and are provided with various insurance plans from which to browse, compare, and purchase. Depending on income level, consumers may be able to receive varying subsidies to help pay deductibles and co-payments.

Why An Exchange?

By providing competition in a regulated marketplace among insurance providers, the hope is to draw down the cost of plans for consumers. Insurance premiums vary by region and state. It is important to remember that customers can only purchase insurance during open enrollment periods, typically from October to December, unless they meet certain exceptions like losing a job, marrying, or having a child. Even more importantly, some cheaper plans come with large deductibles and high out-of-pocket costs so close comparison of plan specifics is encouraged. Another benefit of establishing a health insurance exchange, consumers may contact call centers that are associated with each state and federal website to speak with specially trained advisers who can help answer any questions and clarify the process as a whole.

How Do I Use The Marketplace?

The federal healthcare website is a good resource to locate your specific state health insurance exchange or for more answers regarding specific questions and policy requirements. The site is pretty user friendly, but the process is still lengthy.

 

  • Step One: Preview prices and plans
  • Step Two: Create an account
  • Step Three: Complete your application
  • Step Four: Review your eligibility for any government subsidized plans.
  • Step Five: Pick a plan
  • Step Six: Complete your enrollment and pay your premium

 

If you have any trouble with this process, healthcare.gov offers 24/7 customer service support. Just call 1-800-318-2596! If this still isn’t working for you, or you don’t have access to a home computer, you can apply by phone (same number), by mail, or seek out help from a local community health center or other county office.

Last Updated: December 15, 2014