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Health Care Reform:

Health Insurance & Affordable Care Act

Your Guide to the New Insurance Marketplaces


You can also fill out paper applications or apply over the phone. The federal and state exchange sites have toll-free numbers where consumers can find information about getting help in person.

Are exchanges the only place where I can get subsidized coverage?

Not exactly. Under a little-known rule proposed by the administration in June, consumers will be able to buy an exchange-approved plan - and receive a health law subsidy - from the insurance company itself rather than from the exchange.

I am on Medicare. Do I need to use the exchange?

No. Medicare is not part of the health insurance exchanges. As a Medicare beneficiary, you can enroll in the program’s traditional drug coverage or in a Medicare Advantage plan, where Medicare enrollees get coverage through private health insurance plans, on during the Medicare open season, which begins Oct. 15.

What about federal workers?

Most federal workers will continue to get their health coverage through the Federal Employees Health Benefits Program (FEHBP) and not be required to purchase coverage through the health law’s marketplaces. Members of Congress and their personal staffs, however, will be required to buy health insurance through the exchanges.

A proposed rule from the Office of Personnel Management said the government would continue its practice of paying up to 75 percent of the premium, as it does for federal workers enrolled in FEHBP. Members of Congress and their personal staffs will not be eligible for the health law’s subsidies and will purchase on the exchange in the state where they live, the agency said.

Will exchanges be like travel websites or some existing health insurance sites?

In some ways, but they will be more complex. People will be able to compare policies sold by different companies. Information on the plan benefits will be standardized in an effort to make it easier to compare cost and quality. Plans will be divided into four different types - bronze, silver, gold and platinum - varying based on the size of their deductibles, copayments and other consumer cost-sharing. They will also have to provide personal financial information and citizenship status that will be linked to the Internal Revenue Service and other government agencies.

Mon, Sep 16 2013

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