Q: Are there any standards that health insurance companies in exchanges will have to follow, or will they be able to cover only what they want to?

Image

Answer:

All policies must cover “essential health benefits.” The law defines these benefits. They include a broad and comprehensive spectrum of health services, such as maternity care and prescription drugs. In addition, each state has selected a base plan for their exchange. This plan is intended to represent the most popular small group health insurance plan offered, and it will serve as the base model for all of the plans that will be offered in the exchange.

Higher tiered plans, such as Gold and Platinum, can offer additional benefits. These plans have different cost-sharing requirements for the insured individual.

Ask Your Qusetion

Meet the experts to answer the commonly asked questions to help you understand the Health Care Exchange

Image

Linda V. Tiano

Member of the Firm at Epstein, Becker, and Green in Washington, DC and New York

Image

David Randall

Senior Vice President of Strategic Planning and Business Development at the University of Alabama at Birmingham Health System.

Image

Marti Lolli

Director of Health Care Reform at Priority Health in Michigan.

Ask The Expert
Questions about the Health Care Exchange program?

50 words

ASK
Round
Ask the Expert

Thank you! Your question has been submitted. Close to return to our Expert's page.

Round