Access Exchange for Faster Medical Coverage

One of the major contributions of the Patient Protection and Affordable Care Act is the formation of the state based health insurance Exchange. The Exchange is will serve as a multi-carrier insurance kiosk and health plans and health information will be easily available for the residents.

The insurance market place will be tightly regulated. Only those companies that sell the cheapest plans on the Exchange, spend a minimum of 80% of their premium dollars on healthcare facilities and have the license to sell insurance in the state will be able to do on the Exchange. The rates and the medical coverage of the health plans will also be under the scanner.

Similarly, there are rules for the consumers as well. Initially the Exchange will be open only to residents looking for individual policies and small businesses wanting to provide coverage to their employees.

There have been speculations that the residents wanting to purchase to health plans have to undergo a waiting period. Many believe that they have to remain uninsured for a certain period before they can apply for a medical policy through the Exchange.

However, the truth is completely otherwise. Residents will be able to purchase plans through the state based insurance platform as soon as the Exchange go live in 2014. In fact, purchasing a policy from the health insurance Exchange would be much faster process as:

- E-apps get processed faster
- Residents will not have wait for their applications to get approved as no one will be denied coverage on the basis of any pre-existing medical conditions
- Exchanges will serve as a one-stop shop where residents can get all the insurance need they need, compare plans across companies and finally purchase plans- all on a single platform
- Residents do not have to worry about nor have to do a separate background check on the insurance companies and the plans as every plan being sold on the state-based insurance platform will have been verified by the Exchange.

Any person from the state can log on the Exchange and purchase health plans as long as he is:

• Self -employed
• Working for a company that provides no or insufficient coverage
• Representing a small business in the state and looking to purchase group coverage for the employees of the firm

The speculation could have arisen from confusion that the residents may have between Exchange and the high risk insurance pool. The Exchange is a market place where insurance are bought and sold. A high risk insurance pool, on the other hand, is a federal fund that will help people to access coverage that are costly due the medical conditions of the patient. In this case, there is a waiting period as the applicants have to wait for the all the verifications to be done for the funding and by the insurance companies.

The idea behind setting up health insurance Exchanges is to ensure that the all residents, despite their age, gender or health status, have access to medical coverage at any given point of time. If residents have to wait for their health plan, then the entire purpose of the Exchange is defeated. Therefore, the speculations about the waiting period are only mere rumors and the truth is farther from that.

Shaun Mike is an expert on health insurance and is currently studying about the intricacies of the state health exchange that are to be formed soon.