Friday, July 11, 2014: Health Insurance Marketplaces in 2014: Behind the Numbers

Health Insurance Marketplaces in 2014: Behind the Numbers

Friday, July 11, 2014
With the first open enrollment period for health insurance marketplaces now completed, an estimated 8 million people have enrolled in new private health insurance plans, with millions more newly enrolled in Medicaid. This briefing will look behind the enrollment numbers to take a detailed look at the demographics of marketplace enrollees, initial consumer experiences with health plans and lessons for next year’s open enrollment period.

What have we learned from the first open enrollment experience and what will it mean for 2015? How did the enrollment experience vary from state to state? How many previously uninsured Americans accessed coverage through the Marketplaces? What do people think of their new coverage? Has access to affordable coverage and care improved? Are ACA’s procedures and safeguards for preventing inaccuracies in the enrollment and premium subsidy process working effectively? A panel of experts addressed these and related questions.

Arnold Epstein, deputy assistant secretary, Office of Health Policy, ASPE, provided a federal perspective on enrollment in the new health insurance marketplaces.

Linda Sheppard, special counsel and director of Health Policy and Analysis for the Kansas Insurance Department, discussed factors affecting the enrollment experience in their federally facilitated marketplace.

Richard Onizuka, chief executive officer, Washington Health Benefit Exchange, offered lessons learned on Medicaid and private coverage enrollment through a state-based marketplace.

Timothy Jost, professor, Washington and Lee University School of Law, and consumer representative to the National Association of Insurance Commissioners (NAIC) talked about implementation from a broad consumer perspective across a variety of states.

Ed Howard of the Alliance and Sara Collins of Commonwealth co-moderated.

Contact: Deanna Okrent (202)789-2300

Follow the briefing on Twitter: #ACAmarketplace

Save Money On Medigap

When we talk about medical or health insurance, then you must get very serious about your health and the money that you have to pay. Medigap should be giving you ample coverage to rely on for the rest of your life. However, sometimes, this coverage can also put a drain on your money. Though Medicare combined with Medigap would not be costing you as much as a generalized health insurance policy, you should still try and look for avenues where you can save money on your Medigap policies. Medical Supplement policies would be supplementing the gaps between your Medicare coverage and your hospital bills. In short, it would be paying for everything that Medicare doesn’t pay for.

However, when you are buying Medigap, you might have to pay more than what you thought out. Take the example of Medigap Plan F. This is the most comprehensive and the most popular Medigap plan that you can get in the market. However, this plan has a very high deductible and because of the large extent of its coverage, the premium would also be higher than the other policies. On the other hand, we have policies like Plan M and Plan N that can reduce the cost of premium and you would be able to save as much as 15 to 20% of the premium being paid towards Plan F.

Plus, the money paid towards Medigap policies will differ from company to company and from state to state. This means that you still have some scope to save your money. Here are a few simple ways in which you can do the same.

Make Use Of The Open Enrollment Period

The open enrollment period is the best time to take a Medigap policy. This enrollment period starts as soon as you reach 65 years of age or when you enroll for Medicare Part B. In short, whenever you become eligible for Original Medicare, your open enrollment period for the Medigap policies also starts. In the light of this period, you would be finding a six month long enrollment window. You can go to any insurance company you like and enroll for any plan that you prefer. No insurance company has the right to deny you any coverage. This is true even when you have suffered from some diseases in the past and when you have some pre-existing condition. This means that medical underwriting does not hold any value during this open enrollment period. On top of that, you would not have to shift to a waiting period. This waiting period is the time that the company deems suitable for you when you do not get any coverage. This kind of atrocities are completely removed during the open enrollment period. The company cannot even charge a higher price than their normal quote just because of your age or your health condition. It is truly ‘open’ in nature. However, if you have crossed even a single day of this period. You would have to go for medical underwriting, waiting periods or even be denied coverage.

Find The Plan That Really Suits You

The first and the foremost thing that you can do is find a Medigap plan that really suits your needs and medical coverage. In general, we chose a plan that does not work for us. It is quite possible that your plan would not be covering the medical conditions that you are prone to get. On the other hand, it is also possible that you are being covered for the conditions that don’t even apply to you. If you are under covered, then all the money that you pay as an insurance premium goes a waste as it cannot provide ample coverage when needed. If you are over covered, then too you would be wasting your money on something that you totally don’t need. Hence, it is very important to define your need before you get any kind of insurance policy

Understand How Rates Are Calculated

No two companies would ever be providing you the same quote for the same plan because of different methods of premium calculation. Here they are:

  • Issue Age rated- in this policy, you age at the time of issue of the policy would be used to calculate the premium, but it would not be relevant after that. If you are comparatively younger, you would get a cheaper premium quote.
  • No-age rated- age is not a concern in this kind of a premium calculation. They are generally the community based policies where everyone pays the same premium, irrespective of age, sex or lifestyle. They may have a little higher premiums, but they are good investments for the future as the rates do not change so fast.
  • Attained Age Rated- this kind of a premium calculation becomes the cheapest in the beginning but rates increase rapidly as you age. Avoid this if you are younger.