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Health Insurance Exchanges - Five (5) Key Questions Answered

September 20, 2013

A quick look at any social media site, and you may conclude that the “complexity” of the Health Care Reform Exchanges is confusing to the average American. People are overwhelmed and do not know what, if anything, they must do. Others think that efforts to repeal the law will eventually work, and they will not have to do anything. The Health Care Reform Exchanges are here, and for most people, finding insurance on them will be just like enrolling in an employer-provided plan. They will have several plans to compare in terms of benefits covered and price.

To make your journey through the Exchanges as carefree as possible, prepare for any challenges you think you may encounter. With preparation and patience, you can prevent a lot of fear and frustration.

Q1. How will the Exchanges collect monthly premiums (the amount you must pay for health insurance coverage) if I do not have a checking account?

A1. Insurers on the Exchanges must accept the following payments: money orders, pre-paid debit cards, cashier’s checks, paper checks, and bank account transfers. Verify at the time of enrollment that the insurer will accept whatever form of payment you will make. Also, if your means of payment change, let the insurer know.

Q2. Will plans on the Exchanges provide coverage for pre-existing medical conditions?

A2. Under the Affordable Care Act, you cannot be denied coverage due to a pre-existing medical condition. In addition, insurers cannot charge you more (a higher monthly premium) if you have a pre-existing medical condition. Coverage for pre-existing medical conditions is immediate—no waiting periods.

That said, ensure that your health plan provides the necessary coverage. Health plans do not provide coverage for all medical care needs.

Q3. Will the Exchanges sell Medicare Supplement or Medicare Advantage plans?

A3. No, and No. If you are enrolled in Medicare, the Exchanges are not for you.

Q4. Do I have to provide my medical history to receive price and coverage information for an Exchange plan?

A4. No. Because plans have to cover pre-existing medical conditions, there is no need to provide detailed health information when enrolling.

Q5. Can I purchase health insurance from any state Exchange and use my health insurance coverage anywhere?

A5. You can only purchase health insurance from the state Exchange connected to your state. If your state chooses not to operate its own Exchange, the federal government will operate it on its behalf.

Some Exchange-based health insurance plans may allow you to receive medical care anywhere in the U.S. other plans may restrict where you can receive care. Review the specific plan details to determine where you are eligible to receive care.

With some knowledge and preparation, you can minimize your anxiety about purchasing health insurance on the Exchanges.

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