A Guide to the New Exchanges for Health Insurance

A Guide to the New Exchanges for Health Insurance – NYTimes.com.

 I recommend following the link for a very excellent Q & A/ FAQ at the end.

But after much anticipation, the curtain will finally rise on the exchanges next week, providing millions of consumers with an online marketplace to compare health insurance plans and then buy the coverage on the spot.

The exchanges are likely to be most attractive to people who qualify for subsidized coverage. Individuals with low and moderate incomes may be eligible for a tax credit, which can be used right away, like a gift card, to reduce their monthly premiums. People with pre-existing conditions will no longer be denied coverage or charged more (this applies to most plans outside the exchanges, too). And all of the plans on the exchanges will be required to cover a list of essential services, from maternity care to mental health care. (emphasis added)

CORRECTION: ALL major medical plans off or outside the exchange offer the exact same benefits and guarantees as plans on the exchanges. Plans on the exchange will also be offered off the exchange.

As the article implies, the only reason to apply on the exchange is to get subsidies or you can apply for Medicaid coverage as well by the exchange process.

I do object to the metaphor that subsidies are like “gift cards”! A subsidy can turn into a substantial liability. If your income changes (increases) and you do not report it to the exchange, you may find yourself with a substantial obligation when you file your taxes to refund subsidies you received but were no longer eligible for.


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