Healthcare Exhange

While we are still several months away from open enrollment into the State Insurance Exchange more and more information being released regarding the status of state insurance exchange implementation. It appears each state is making progress and meeting deadlines established by the Affordable Care Act in the development of the insurance exchange system. Medicare Pathways wants to keep you informed regarding your state’s status of state insurance exchange implementation and help you understand where your state is with regard to the development of the insurance exchange. It is hard to understand the status of state insurance exchange implementation without understanding the key terms that are used to identify the exchange system.

Status of State Insurance Exchange Implementation – key terms to understanding the status of your state’s insurance exchange

You may know which type of state insurance exchange your state has chosen to implement, but do you understand what it means? The following are some important terms and explanations that will help you understand the information that you may be reading regarding your particular state’s status of state insurance exchange implementation:

Status of State Action:

  • Declared State-Based Exchange – state has indicated that it will establish a state-based exchange;
  • Planning for Partnership Exchange – state has indicated that it will partner with the federal government to operate an exchange
  • Default to Federal Exchange – state has indicated that it will default to a federally facilitated exchange.

Federal Approval Status:

  • Conditional Approval – The United States Department of Health and Human Services (hereinafter referred to as “Health and Human Services” or “HHS”) has reviewed the state’s blueprint application and found that the exchange is making progress and is expected to be ready for enrollment on October 1, 2013;
  • In Review – state’s insurance exchange blueprint application is in review with Health and Human Services;
  • Blueprint not yet submitted – state has not yet submitted the exchange blueprint application for a partnership exchange to Health and Human Services for review.

Status of State Insurance Exchange Implementation – structure of the types of exchanges.

States have flexibility in determining the role of the exchange with respect to contracting with health plans. All exchanges are required to contract only with health plans the meet minimum federal requirements for qualified health plans. States can choose to have the exchange contract with all qualified health plans (clearinghouse) or states can choose to have the exchange contract with selected health plans and/or negotiate premium prices with health plans (active purchaser).

Stay informed regarding the status of the state insurance exchange implementation by visiting our news blog. While Medicare Pathways specializes in Medicare insurance, such as Medicare Advantage, Medicare Supplement and Prescription Drug Plans, it is our goal to be able to answer questions regarding not only Medicare insurance, but individual concerns regarding the status of issues that deal with the Health Care Act, including the status of State Insurance Exchange Implementation.

Contact a Medicare Pathways Benefit Advisor by calling 1-866-466-9118 to discuss your Medicare insurance needs or concerns. You can also Request a Quote, complete a short form, and a Medicare Pathways Benefit Advisor will contact you. Keeping everyone informed of the status of original Medicare as well other issues that affect our country and concerns of our clients is a goal of Medicare Pathways.

Stay informed! Visit our News Blog!

Medicare Pathways: 1-866-466-9118