Health Insurance Marketplace | Health Insurance Exchange

In the United State of America, there is health insurance marketplace, where you can make a purchase of health insurance in different state in the U.S. The health insurance marketplaces or health exchanges is working in accordance to the Patient Protection and Affordable Care Act. This marketplaces give a roll of government-regulated and standardized health care plans, which helps individuals buy health insurance policies eligible for federal subsidies.

The date that health insurance marketplaces or health exchanges was ready and passed to become operational in U.S was on the 1st of January, 2014, in accordance with Federal law. Registration into the marketplaces commenced on October 1, 2013, and lasted for six months. The existence of Health insurance marketplace , does not mean that there is no private non-ACA health care exchanges as they do exist in the many states in the US. They are saddled with the responsibility to enroll 3 million people. These exchanges predate the Affordable Care Act and facilitate insurance plans for employees of small and medium size businesses.

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What You Should Know About Health Insurance Marketplace In The United States

In the United States, health insurance marketplace, is designed to help insurers comply with the "Consumer Protection laws" expand insurance coverage to more people and compete in cost-efficient ways. Exchanges should not be seen as insurers, because they have no risk to bear, what they do is determine the insurance companies that are allowed to participate. To transmit basic information amongst the Exchanges and Carriers, Health insurance marketplace uses " Electronic Data Interchange (EDI).

Meanwhile, Tracing the history of the Health Insurance Exchange or marketplace, one will be led to when it was first found in the early 1980s, by a private sector. As at that time, they used computer networking to integrate claims management, eligibility verification, and inter-carrier payments. In some regions it gained popularity as an opportunity for small and medium-sized business to pull their purchasing power into lager group, thereby reducing cost. The largest of such exchange that was prior to the ACA is the CaliforniaChoice, which was established in 1996. By 2000, CaliforniaChoice’s membership included 140,000 individuals from 9000 business groups.

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Patient Protection And Affordable Care Act Regulation

1. Insurers are not allowed to charge high rates for any personal based on pre-existing medical conditions or prohibited from discriminating against any individual.


2. Insurers are prohibited from creating annual spending caps of dollar amounts on essential health benefits.


3. The Patient Protection and Affordable Care Act eliminates lifetime and annual limits from plans in the individual health benefits exchanges. This effectively eliminates the ceiling on financial risk for individuals in the individual exchanges.


4. All private health insurance plans offered in the Marketplace must offer the following essential health benefits: emergency services, maternity and newborn care, mental health and substance abuse services, ambulatory care, etc.

You should also know that a health plan bought via the marketplace otherwise called exchange will qualify minimum essential coverage. So will not pay the fee for not having insurance. Through your states marketplace, you can verify if you are eligible for CHIP or Medicare, and Medicaid.