Wednesday, August 13, 2014

Exchange vs Marketplace vs Obamacare vs ACA

What's the difference?

To keep people confused, they are all parts of the same thing.

The Exchange / Marketplace -  Same thing, kinda.  Healthcare.gov is the website that is used to 1) get tax credits for health coverage, and 2) apply those credits to an insurer's health plan.  An individual does not need to go through this website in order to get enrolled, a licensed agent may have a method to do this primarily through an insurer.  However, at some point, the Marketplace will become involved if tax credits are involved.  This is only true if an individual is seeking a tax credit.  Tax credits are based primarily on income and family size.  Without a tax credit, no information is shared with the government and a health plan enrollment can be done entirely through a licensed agent.  Most people I've spoken with, including insurance agents, were overwhelmed with the complexity of this process.  If you don't do your own taxes, you shouldn't attempt this on your own either.  Have someone familiar with the process and licensed to do so assist you.

Obamacare - There is no such thing.  What ?  It's branding.  The term 'Obamacare' is used to make people think that the President created this in its entirety and if there are any negative connotations this term will be used.  You will typically only hear this in a negative connotation.  However, the laws were written and approved by Congress and actually initiated by President Clinton in 1993.

ACA - Patient Protection and Affordable Care Act (PPACA) is the proper term.  In 'the biz', we define certain plans by saying if they 'are ACA' or 'are not ACA'.  This just means that they are or are not compliant with the Act. 
Non-ACA health plans still exist, some of which are major medical plans that have been 'grandfathered'.  These are slowly going away but some people were able to keep their plans.  (Obama didn't 'take away your plan')  Other non-ACA plans are fixed benefit plans, temporary major medical plans, as well as a number of ancillaries and government insurance like Medicare and Medicaid. 
ACA plans are also known as 'compliant plans' as in compliant with the Act.  They are major medical plans and provide a certain set of benefits as required by law.  They are more comprehensive than major medical plans of the past and are normally a higher monthly premium if tax credits aren't applied.

FYI: For good protection, if you are healthy you may find that going with a non-ACA plan and paying the IRS penalty is actually cheaper in the long-run.

A 'good agent' will help protect you while still staying within your budget.

For assistance in navigating the complexity of the new health options, please contact me through psyberquote.com .

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