Getting Ready for the Health Insurance Marketplace

Article at a Glance

• The new Health Insurance Marketplace will be ready starting October 1, 2013.
• The Marketplace will make shopping and applying for health insurance simpler and more transparent.
• Before October you will want to think about what health insurance is already available to you, what you are looking for in a health plan, what your budget will be, and whether or not you may qualify for assistance.

Coming in October, individuals will be able to start enrolling for insurance coverage using the new Health Insurance Marketplace.

The Health Insurance Marketplace is an online, competitive marketplace where individuals, families, and small businesses can shop for private insurance. The marketplace is intended to make shopping for health insurance easier and more transparent. Here are some of the key features you can expect to see.

• A single form will be used for applying for health insurance—meaning less paperwork to fill out and less confusion.
• There will be rules on how companies can offer and price insurance, and how they provide information about their plans. Companies will be required to list everything clearly, upfront, and without any misleading information.
• You will be able to compare plans side by side according to benefits and price.
• There will be unbiased advisers you can call for help who aren’t affiliated with any plan and who don’t receive any commission.
• All plans in the Marketplace will be required to offer comprehensive coverage that includes things like doctor visits, medications, and hospital visits.

So far Utah is the only state that will have two marketplaces. Utah already has the state-run Avenue H, which is designed for small-businesses and was opened in 2010. The federal government will be managing the new marketplace intended for individuals.

What You Will Need to Consider
Before October, you will want to ask yourself some questions.

What kind of insurance is available to me?
Can you currently get insurance through your employer or through the employer of a spouse or parent? Is your employer planning on offering coverage under the new law in 2015? Do you qualify for Medicaid either now or in the future?

What kinds of things am I looking for with my medical coverage?
Do you want to be able to stay with your current doctor? Do you need a plan that will cover you if you will be residing out of state? Do you or your family have any special medical needs?

Do I know how health insurance works?
Knowing about things like copays, deductibles, and out-of-pocket maximums will help you make better decisions when shopping for health insurance. You can learn more at the government’s website – www.healthcare.gov.

How much do I want to budget for health care?
Different plans will have different levels of coverage. Decide how much you can and want to budget.

What is my income?
Pull together information about your household income. This will help you check to see if you qualify for federal assistance.

Thinking about these things ahead of time will help you decide whether or not it makes more sense to go through your employer (when possible) or to sign up for private insurance through the Marketplace.

In the next article we will be covering whether or not you have to purchase health coverage and what kind of financial assistance you can expect from the government.