July 09, 2013
By Mark Moran
Beginning October 1, patients can enroll in the new Health Insurance Exchanges established by the Affordable Care Act.
Clinicians are urged to alert their patients to this important approaching date, to make them aware of this new option for health insurance coverage, and to discuss with them the possible benefits associated with this new way of accessing insurance coverage for medical care. Health insurance exchange plans offer the full range of benefits—including for psychiatric care—with no exclusions for preexisting conditions and no lifetime limits on benefit amounts.
Clinicians should note that some patients may require help in creating an account, applying for a plan, and maximizing their benefits and their cost savings.
Importantly, many low-income patients may qualify for cost savings and subsidies.
The health insurance exchanges, also known as the “marketplace,” simplify the search for health coverage by gathering together in one place all the options available within a geographic area. With one application, patients can compare plans based on price, benefits, quality, and other features important to their medical needs. Patients, families, and clinicians can also get help online, by phone, by chat, or in person.
Information about prices and benefits is written in simple language, and individuals will get a clear picture of the premiums as well as the benefits and protections to which they are entitled before enrolling.
However, health exchanges vary from state to state in how well developed they are, and some states are choosing not to participate. Some states are well into the process with established Web sites, while many others have nothing posted yet. Patients and clinicians can sign up for updates so they can be alerted for changes as state exchanges evolve.
The Centers for Medicare and Medicaid Services has established an online resource that provides individuals all the information they will need to get started at https://www.healthcare.gov/marketplace/individual. Psychiatrists and patients can find information on the plans and assistance available in their state at https://www.healthcare.gov/what-is-the-marketplace-in-my-state.