Understanding Health Insurance Exchanges

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While the US healthcare industry has been witnessing a lot of changes over the past few years, The Patient Protection and Affordable Care Act (PPACA commonly known as ACA), has introduced yet another revolutionary reform recently. It is the Health Insurance Exchange Marketplace which took effect from October 1^st 2013. It is believed that ACA exchanges or online health insurance marketplaces would offer affordable health insurance coverage to almost 29 million US citizens in the near future. However, healthcare providers will have a tough time implementing this new change as it will highly impact medical insurance billing processes. Let’s take a brief look at the important features of Healthcare Insurance Exchanges and their impact on healthcare providers:

Salient Features:

· People can enroll for ACA Health Insurance Exchange Marketplace between the time span of October 1^st 2013 and March 31^st 2014.

· The best part about these health insurance marketplaces is that they offer a wide range of options for US citizens to choose from. This way they can compare the coverage options and costs based on their annual or monthly income.

· These marketplaces also offer subsidies to those citizens who currently don’t have one. However, the coverage plan and their costs vary from one state to another.

· The law will charge a per-month fee on one’s year-end tax returns if he or she doesn’t have insurance by January 1^st 2014. However, a person will not be subject to this fee deduction if he or she has other health insurance coverage plans like COBRA, TRICARE, Medicare, Medicaid and more.

Special Features: ACA Health Insurance Exchange Marketplaces provide special offers to those citizens who receive a low income.

• US citizens who make less than 138% of the Federal Poverty Line will receive cost assistance from Medicare/CHIP.
• US citizens who make up to 250% of the Federal Poverty Line will receive out-of-pocket cost assistance.
• Premium tax credits are provided to those who make up to 400% of the Federal Poverty Line in order to minimize monthly premium costs.

Impact on healthcare Providers: As healthcare providers are having a hard time implementing the previously proposed medical reforms, the ACA Health Insurance Marketplace has become an added burden with the addition of new patients with Insurance cover. Implementing these changes will definitely require a lot of time and man power during which the medical insurance billing functions are likely to get affected. In order to keep the medical claims billing processes running smooth and uninterrupted, healthcare providers must outsource medical billing. This way they can balance their work efficiently.

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