Quick, what's an insurance exchange? If you're like most Americans, you have no idea.
But it's about to alter the way millions buy health insurance when it opens in 10 short days.
For Americans still waiting to decipher how the insurance exchange works and whether it applies to them, now is the time to sit up and figure it out.
Read on.
What is the new federal health-insurance exchange?
The federal exchange is an online government website (healthcare.gov) where consumers may shop for and compare health insurance plans that vary by county. Under the health-care overhaul, all Americans must have health insurance in 2014 or pay a penalty. That is known as the mandate. Florida is among more than two dozen states that elected to use the federal exchange rather than set up a state exchange.
How do I know if I should shop for health insurance on the exchange?
The health insurance exchange could benefit more than 1.7 million Floridians, but it's not for everyone, said Ron Pollack, executive director of Families USA, a nonprofit health-advocacy organization.
Those who will benefit most are middle-income citizens who earn 100 percent to 400 percent of the federal poverty level, and don't have employer-sponsored health insurance. They will be able to access coverage and could receive tax credits through the exchange, said Larry Levitt, senior executive for the Kaiser Family Foundation, a nonprofit health-advocacy organization based in Washington.
However, those who have good coverage through their employer, or who are older than 65 (and therefore eligible for Medicare), or who qualify for Medicaid or other government programs should not shop for insurance on the exchange.
Also lower-income individuals and families who earn less than 100 percent of the poverty level and don't qualify for Medicaid won't be eligible for tax credits through the exchange, said Levitt.
If I have a pre-existing condition, will it cost me more for coverage or will I be denied?
No. Starting in 2014, no insurance company can deny you coverage, cancel your coverage or charge you more because you've been diagnosed with a health problem or are a woman, said Pollack. That is true for insurance policies purchased on or off the exchange. Furthermore, insurance companies cannot refuse to cover your medical condition.
I've never bought health insurance before. How do I know which program is best for me?
When you go through the online application process on the government website, the program will let you know whether you're eligible for Medicaid. If you're not, it will let you know if you're eligible for a tax credit to help offset the cost of insurance based on your household income and family size, and if so how much.
Once you know what your estimated tax credit will be, you can shop and compare the health plans available in your county, said Levitt.
How do I enroll?
There are several ways to apply for health insurance on the federal exchange, said Fabien Levy, spokesman for the U.S. Department of Health and Human Services: by visiting the website healthcare.gov; by calling 1-800-318-2596; by sitting down with a navigator or other certified representative of the exchange; or by filling out and mailing in a paper application, available from local navigators, insurance agents or community health centers.
When applying, you will need Social Security numbers, income information from W-2s (or recent tax returns) for everyone in your household needing coverage, and information about your current health insurance plans, if any. If you have questions, you may chat live with those on the exchange or call the toll-free number.
You may also seek in-person help from navigators or other certified assistors trained to help consumers sort through their options, or from other community resources, said Levy.
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