Health Insurance Exchanges 101
Health insurance as we know it is going to change dramatically in 2014. There will be a new way to “shop” for insurance through an avenue called health insurance exchanges or health insurance marketplaces. The exchanges will become available for private insurance and will provide a “one stop shop” to be able to compare and contrast plans to best fit your individual needs. The premise is that insurance companies such as Blue Cross and Blue Shield and Cigna will go through an approval process and become part of the exchanges. Which companies are participating will be specific to each state. Health Insurance Exchanges 101: Let’s get started!
There will be 4 plans available which are referred to as the “Metal Plans”. They will be referred to as Platinum, Gold, Silver, and Bronze. In order for a company to participate in the exchanges they must offer at a bare minimum at least a Gold and a Silver plan. The difference between the plans is the amount of coverage provided. In general, the higher the coverage, the higher the premium. The average coverage will range from 60% in the bronze plan up to 90% in the platinum plan. Within each plan within each state, there will be different plans and different premiums. This is where the marketplace concept comes into play.
The application process will be online for the most part with an opportunity to enroll by phone and possibly individual kiosks for those that aren’t computer literate and or don’t have access to a computer. Open enrollment begins October 2013 and we encourage you to check with the resources for your particular state to begin reviewing your options. It is important to note that these exchanges are for individual insurance and those with group coverage through their employers will not be affected. Following is a video which explains the basics of the exchanges.
About BHM Healthcare Solutions – www.bhmpc.com
BHM is a healthcare management consulting firm whose specialty is optimizing profitability while improving care in a variety of health care settings. BHM has worked both nationally and internationally with managed care organizations, providers, hospitals, and insurers. In addition to this BHM offers a wide breadth of services ranging including managed care consulting, strategic planning and organizational analysis, accreditation consulting, healthcare financial analysis, physician advisor/peer review, and organizational development.
Contact Us : results@bhmpc.com, 1-888-831-1171
Visit our Insights page to stay up to date on new healthcare policy measures and upcoming laws.
Would you like to learn more about Medical Necessity Criteria? Please click the image below and enjoy a full presentation.
