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 Get Ready for the New Health Insurance Marketplace


Major changes related to the passage of the Affordable Care Act take place in 2014. According to Dr. Rhonda Johnson, medical director of health equity and quality services at Highmark, you may want to cut this article out and keep it for future reference.

The New Health Insurance Marketplace

One of these changes will be in the way people will get health insurance. A new health insurance marketplace, sometimes called “exchanges,” will change the way health insurance coverage is purchased. Consumers will be able to buy insurance directly from the health insurance marketplace. In addition, more people than ever before will qualify for free or low-cost health insurance programs. 

  Here’s a brief list of what to expect in the new “exchanges” in 2014:

  • People will be able to compare all their health insurance options in one place.
  • Health plans offered in these exchanges will have to meet state and federal standards. 
  • Health insurance will also be more affordable for many families.
  • All your costs are stated upfront, so you will know what your expenses will be.
  • Health insurance companies can't exclude you or charge you more for pre-existing conditions or chronic conditions (such as diabetes or asthma). 
Who is eligible?
Anyone can use the health insurance marketplace to explore his or her health insurance options, even if you already have insurance now. The only requirements to get insurance through the marketplace are:
  • You must live in the U.S.
  • You must be a U.S. citizen or national (or lawfully present)
  • You can’t be currently incarcerated

Get prepared 

Between now and October 2013, expect to hear, see and read a lot more information about these new exchanges.  In the meantime, here are a few tips to  get ready:

  • Learn about different types of health insurance. Through the marketplace, you’ll be able to choose a health plan that gives you the right balance of costs and coverage.
  • Make a list of questions you have before it’s time to choose your health plan. For example, “Can I stay with my current doctor?” or “Will this plan cover my health costs when I’m traveling?”
  • Make sure you understand how insurance works, including deductibles, out-of-pocket maximums, copayments, etc. 
  • Start gathering basic information about your household income. You may qualify to get a break on costs, and you’ll need income information to find out how much you’re eligible for.
  • Set your budget. There will be different types of health plans to meet a variety of needs and budgets, and breaking them down by cost can help narrow your choices. 
  • Find out from your employer whether it plans to offer health insurance, especially if you work for a small business.
  • Explore current options. You may be able to get help with insurance now through existing programs or changes that are in effect already from the new health care law. 
Where to go for more information
A great resource to get information about health insurance reform is http://www.healthcare.gov
Dr. Rhonda Johnson (pictured above) is the medical director of health equity and quality services at Highmark Inc. She leads Highmark’s efforts to reduce racial and ethnic health care disparities among Highmark members through clinical interventions and improvements in health literacy, language access and health plan cultural competency. 
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