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New Year, Newly Insured

January 1, 2014

Overcoming significant hurdles since the launch of the website on October 1, 2013, an estimated 2.1 million Americans have enrolled in private health insurance plans offered through the newly created health insurance marketplaces. While this is a marked improvement from the initial enrollment numbers, it still falls short of the administration’s projections. 

Some of the lower-than-anticipated enrollment numbers are attributed to technical difficulties that plagued the 34 federally operated and 14 state-based websites for the last several months.  However, with recent improvements to the websites, the administration expects that the projected 7 million people will select plans before the marketplace open enrollment period ends on March 31, 2014. In addition, roughly 4 million people have qualified for coverage through their state Medicaid and Children’s Health Insurance Program (CHIP).

In anticipation of potential confusion for those individuals whose coverage began January 1, 2014, the administration released a tip sheet that urges them to take certain precautions before using their insurance for the first time. It also advises them about what to do should they have difficulties.  Insurers and medical and pharmacy providers are also aware of certain issues, such as people not having their insurance card and lacking proof of credible coverage. Consumers are urged to follow up with their marketplace and insurer to verify their enrollment. If you’re enrolled in a federal or state partnership marketplace, contact the marketplace call center: 800.318.2596. If your state is operating its own marketplace, visit your state’s marketplace website.

There have been significant improvements for consumers shopping for plans in the marketplace, namely the ability to make comparisons between plans’ premiums, copayments and deductibles. However, figuring out the plan’s network is still cumbersome. Consumers will need to compare plans and evaluate whether providers, including their hemophilia treatment center and specialty pharmacy, are in network and what costs are associated. The marketplace sites allow consumers to narrow their choices based on several parameters but consumers should expect to compare plans across different metal tiers (e.g., gold, silver) to make their decision. NHF strongly encourages consumers to use the newly updated Health Insurance Toolkit (found here) to help facilitate the process.