19 Dec 2018

How Does the Healthcare Marketplace Work?

How Does the Healthcare Marketplace Work?

**Healthcare Marketplaces were set up as part of the Affordable Care Act to make it easy for Americans to compare and shop for private health insurance plans during the Open Enrollment Period.**

What is the Healthcare Marketplace?

The Health Insurance Marketplace was established in 2010 as part of the Affordable Care Act (ACA) to ensure all Americans have access to health insurance.

The Health Insurance Marketplace, sometimes called the “exchange,” is a platform that lets you shop for and enroll in affordable health insurance services.  The platform provides a central location for individuals or families without employer-sponsored coverage to easily compare options and purchase plans provided by private health insurance companies.

Even though the Marketplace is run by the government, the plans are provided by private insurers.  In most states, it’s run by the federal government and can be accessed at HealthCare.gov but, some states chose to build their own Marketplace with their own unique names.

How does the Healthcare Marketplace work?

Put simply, the Marketplace is a portal that makes it easy for you to compare and purchase health insurance.  It also provides answers to common questions about health insurance and tax credit eligibility.

While it is pretty straightforward, there are still some things you need to be aware of.

Open Enrollment Period

During the Open Enrollment Period (usually in November and December), Americans can compare and apply for plans via the marketplace.  But if you miss the date due to childbirth, marriage, or some other kind of qualifying event, you may be able to apply for a special enrolment period.

Plan Tiers

To make shopping even easier, the Marketplace categorizes plans into 4 tiers: bronze, silver, gold, and platinum; with bronze offering the least coverage and platinum offering the most.  Bronze plans are the least expensive but usually only cover 60% of your healthcare costs.  Platinum plans are expensive but many of them will cover up to 90% of your health expenses.

Essential Health Benefits (EHB)

Even though plans on the Marketplace can vary widely, all plans sold on the platform must meet the 10 basic requirements set out in the essential health benefits which vary from state to state.  Examples of mandatory coverage include outpatient care, hospitalization, rehab, and newborn and maternity care.

Automation

Picking the right plan may be difficult but the process of purchasing a plan is very streamlined and highly automated for your convenience.

When you enter the Marketplace, they will ask you for your ZIP code.  If you live in an area with a state-based Marketplace, the system will automatically redirect you to your state’s Marketplace website.  Once you pick a plan on the marketplace, your enrollment file is automatically sent to the insurer who collects the first month’s premium, sends out an ID card, and starts your coverage.

Need help?

While using the Healthcare Marketplace is pretty straightforward, picking a plan is not.  The plans almost seem like they were designed to be confusing.  But, you don’t have to figure all of this out on your own.

The professional and friendly licensed health insurance agents at HealthQuoteInfo.com are here to help.  Call us at 1-855-614-5057 for a quick quote and unbiased advice to make sure you have the right coverage.

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