A health insurance exchange, otherwise known as a health insurance marketplace, is a comparison-shopping area for health insurance.
Private health insurance companies list their health plans with the exchange, and people comparison shop on the exchange from among the available health plan listings
.
What are health exchanges designed to offer?
The Affordable Care Act (ACA) requires that health insurance exchanges be established in every state by January 1, 2014. The central purpose of these new Marketplaces is to
enable low and moderate income individuals, and small employers to obtain affordable health coverage
.
What are the primary goals of health insurance exchanges?
The law has 3 primary goals:
Make affordable health insurance available to more people
. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level (FPL).
How do private exchanges work?
Private exchanges are typically administered by a benefits broker or consultancy.
Employers give each eligible employee a fixed amount each month to spend on plan premiums, and the employee pays the rest of the cost, choosing among differently priced plans from competing insurers
.
What's the difference between on exchange and off-exchange?
If you buy your health insurance through the health insurance exchange in your state (on your own, or with the help of a broker or enrollment counselor), it is considered an “on-exchange” plan.
If you buy it directly from the insurance company (on your own, or with the help of a broker), it's off-exchange
.
What are the exchanges mandated by the Affordable Care Act?
The ACA establishes two types of insurance exchanges:
the American Health Benefits Exchange (AHBE) for individual purchasers and the Small Business Health Options Program (SHOP) for businesses with fewer than 100 employees
, although until 2016, states retain the discretion to limit eligibility to businesses with fewer …
What is true regarding the cost of medical exchanges?
What is true regarding the cost of medical exchanges?
Services are priced based on a sliding scale
. What is the role of robotics in surgical procedures? Robotics enhance the surgeon's skills.
What is the purpose of the health Benefit Exchange?
The California exchange's vision is
to improve the health of all Californians by assuring their access to affordable, high quality care
.
Why were exchanges implemented by the Affordable Care Act?
The exchanges are intended
to increase competition among insurers and focus that competition on value and price
. A number of provisions of the ACA should help to facilitate this objective. Administrative costs. The ACA requires exchanges to fulfill a number of administrative functions that will add to their costs.
What are state based exchanges?
A State-Based Marketplace (SBM) is
a government agency offering subsidized Obamacare plans for the state, similar to Healthcare.gov but created and maintained by the individual state
. SBMs assist citizens and legal residents with applying for marketplace coverage in order to comply with the Affordable Care Act (ACA).
Is the ACA still in effect?
The Rest of the ACA Remains in Effect
Other than the individual mandate penalty repeal (and the repeal of a few of the ACA's taxes, including the Cadillac Tax),
the ACA is still fully in effect
.
What federal legislation created health insurance exchanges that provide individuals with an ability to purchase insurance?
Beyond subsidizing coverage and regulating the insurance and group health plan markets,
the Affordable Care Act
creates state health insurance Exchanges for both individuals and businesses.
What is a private health exchange?
Private exchanges are
marketplaces of health insurance and other related products
. Employers purchase health insurance through the private exchange, and then their employees can choose a health plan from those supplied by participating payors.
What is a private Medicare exchange?
A private Medicare exchange is
a marketplace owned and operated by a company or non-profit organization where Medicare beneficiaries can purchase individual coverage available in their area
.
What is the difference between public health insurance and private health insurance?
The public health care system will cover the cost of your treatment. As a public patient, you cannot choose your hospital, doctor or specialist. When you choose to be treated as a private patient in hospital: your health insurer covers some or all of the hospital costs (such as accommodation)
What is Blue Shield off exchange?
Blue Shield of California Off-Exchange Package for Small Business is
designed to make it easy for you to offer quality healthcare coverage to your employees
. Not available on the SHOP, these plans can be purchased from Blue Shield through a broker.
How are subsidized members different than on exchange members?
The terms “on-exchange” and “off-exchange” can be confusing. Here is the key difference:
On-exchange means those plans that are available on the public exchange only
. If you qualify for a subsidy, and choose to use it on your health plan, then shopping on-exchange is your best option.
Are EPO and PPO the same?
EPO or Exclusive Provider Organization
Usually, the EPO network is the same as the PPO in terms of doctors and hospitals
but you should still double-check your doctors/hospitals with the new Covered California plans since all bets are off when it comes to networks in the new world of health insurance.
Which agency is responsible for implementing the health insurance marketplaces portion of the Affordable Care Act?
The federal agency that oversees CMS, which administers programs for protecting the health of all Americans, including Medicare, the Marketplace, Medicaid, and the Children's Health Insurance Program (CHIP). For more information, visit hhs.gov.
Do ACA subsidies vary by state?
The eligibility requirements for the subsidies are the same from state to state
. All plans, regardless of state, will fall into one of four plan categories: Bronze, Silver, Gold, or Platinum. These four ‘metal plans' adhere to a price structure that matches their coverage rates.
What is the most widely accepted legal definition of death in the United States?
What is the most widely accepted legal definition of death in the United States.
Cardiac death
. Which action is considered active euthanasia. Intentionally killing a terminally ill individual. Ethical considerations of the terminally ill patient include.
What is withholding life sustaining treatment?
The goal of withdrawing life sustaining treatment is to
remove treatments that are no longer desired or do not provide comfort to the patient
. 2. The withholding of life-sustaining treatments is morally and legally equivalent to their withdrawal.
What type of audit is performed internally after claims are submitted?
An audit can take two forms. Prospective audits are performed before claims submission and
retrospective audits
are performed after claims have been paid. Both forms of audit should be conducted regularly, and can be conducted by an internal staff or by paid, outside consultants.
What is individual exchange?
Another term for the Health Insurance Marketplace®,
a service available in every state that helps individuals, families, and small businesses shop for and enroll in affordable medical insurance
.
What does Hix member mean?
Marketplace (
Health Insurance Exchange
“HIX”)
Health Plans. All health plans must offer the same essential health benefits. These benefits include coverage for things like: • Doctor visits.
What is the marketplace exchange?
The Health Insurance Marketplace® (also known as the “Marketplace” or “exchange”)
provides health plan shopping and enrollment services through websites, call centers, and in-person help
.
