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The Health Insurance Marketplace: State-based vs. federally facilitated exchanges

Before the healthcare reform policies of the Affordable Care Act, it was very difficult and confusing for consumers to compare and contrast the huge array of different health insurance policies available on the market. To help both individuals and small business owners deal with this cumbersome and often dreaded task, the health insurance exchanges, or marketplaces, were born.

What are health insurance exchanges?

Simply put, health insurance exchanges are virtual marketplaces where individuals and small business owners can compare and purchase private health insurance coverage. People who aren’t covered by health insurance programs like Medicare, Medicaid, the Children’s Health Insurance Program (CHIP) or through their employment can purchase coverage through these marketplaces.

The primary aim of insurance marketplaces is to simplify the process of gathering pertinent comparative information regarding available plans, such as price, benefits, services and quality. Basically, these are similar in scope and function to websites that facilitate comparison shopping for things like airline tickets.

Choosing the right plan

Higher quality, easier-to-understand data enables American individuals, families and small businesses to make more informed choices in deciding which insurance plans are best suited to their particular needs. While different plans still offer a wide range of options in terms of levels of copayments, deductibles, coinsurance and other factors, the exchanges simplify the display of comparative policies by creating four basic groups for insurance products: bronze, silver, gold and platinum.

As a “one-stop shop” for health insurance coverage, the exchanges also help consumers identify whether they are eligible for any financial assistance, such as premium tax credits.  These are designed to enable individuals and families with low or moderate income to afford health insurance through credits paid to your insurance company to lower monthly payments.

State-based vs. federally facilitated exchanges

The health insurance marketplaces are administered through state-based exchanges (SBE) by the state itself or through federally facilitated exchanges (FFE) by the Secretary of Health and Human Services (HHS). In addition, some states operate state-based exchanges that make use of the federal IT platform (SBE-FP), www.healthcare.gov, the widely-used federal exchange website.

While most American consumers will use the federal government’s service to apply for and purchase coverage, a number of states have chosen to operate their own exchanges. For 2018, 34 states have FFEs, while 12 states have SBEs and 5 states have SBE-FPs.

The following list indicates the 12 SBEs as well as their individual websites for the application and purchase of health insurance coverage:

  1. CaliforniaCovered California
  2. Colorado Connect for Health Colorado
  3. District of Columbia DC Health Link
  4. IdahoYour Health Idaho
  5. MarylandMaryland Health Connection
  6. MassachussettsMassachussetts Health Connector
  7. MinnesotaMNsure
  8. New YorkNew York State of Health
  9. Rhode IslandHealthSource RI
  10. VermontVermont Health Connect
  11. WashingtonWashington Healthplanfinder

Still not sure where to go for health insurance information in your state? Please visit our interactive map to confirm whether your state’s insurance marketplace is state-based or federally governed.

To learn more about state-based and federally facilitated health insurance exchanges, contact the experts at HealthCareInsurance.company at 855-401-8383. Our licensed insurance professionals are standing by to answer any questions you may have.

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