Providing access to health insurance for millions of Americans is no small task. The Affordable Care Act created an easy and effective enrollment process, while simultaneously creating a Health Insurance Marketplace, or “Exchange” that offers a variety of health insurance options to persons either without insurance or who simply, wish to seek alternative coverage in the free market.
The State of Wisconsin elected to not create a Health Insurance Marketplace, and instead will rely on the plans made available through the federal government. Many individuals and families who until recently have been eligible for BadgerCare programs were directed to the Health Insurance Marketplace to purchase private health insurance. Information regarding the various plans available as well as the application and enrollment process is found at www.HealthCare.gov.
To prepare to enroll, you can learn about types of health coverage, research your questions, and figure out what you need to know before open enrollment begins. After October 1, the Marketplace will offer different types of health plans to meet a variety of needs and budgets. You will be able to compare plans and get an idea as to what premiums you might pay and what benefits you will receive from the plan you may choose. You can choose the combination of price and coverage that best fits the needs of you and your family.
As you compare the plans offered, you’ll see that there are four categories, each offering different levels of coverage and premium payments.
The level of coverage offered affects your monthly premium cost as well as the portion of the bills you pay for things like hospital stays, outpatient procedures, prescriptions and more. It will also affect you out-of-pocket costs- the total amount you’ll spend each year if you require a good amount of medical care. In general, the lower the premium, the higher the out-of-pocket costs. For example, Platinum plans likely have the highest monthly premiums and lowest out-of-pocket costs. All plans must offer a comprehensive set of essential health benefits including doctor visits, preventive care, hospitalization, prescriptions, and more. Plans won’t be able to deny you coverage or charge you more due to pre-existing health conditions, including a pregnancy or disability.
Regardless of which plan you choose, there are many preventive services available to you at no cost. These covered services are a part of each plan.