What is the healthcare marketplace in the US?

October 17, 2019


healthcare marketplace, USA

A modern-day healthcare marketplace is a digital platform for purchase and sale of health insurance rather than an actual physical market. In India, various insurance aggregator sites play the role of quasi-health insurance marketplace. However, they are privately owned and a not regulated by governments. In this blog, Student Cover provides you information about the healthcare marketplace in the US.

In the US, regulated healthcare marketplace, also known as “Insurance exchange”, are virtual spaces that allow insurance providers to list their health insurance plans. The buyers can then compare the costs and benefits of those plans and make purchases accordingly.

Healthcare Marketplace – Public or Private

While the private insurance exchanges do exist in the US and some even predate the Affordable Care Act passed during the Obama Administration, these days they are mostly used to refer to public health insurance exchanges. In Public insurance exchanges, people can buy both individual and family health insurance plans. Those eligible for Medicaid can also access them through the exchange. Private health insurance marketplaces on the other hand usually cater to large organizations and provide employer health insurance plans.

Benefits Offered by Public Healthcare Marketplaces

During Obama Administration, when the Affordable Care Act was passed, a market was envisaged where all Americans can explore and compare benefits of the plans and purchase those that best suited their needs. One of the more contentious provisions of the “ObamaCare Act” was that the health insurance plans listed in the public exchange should comply with its provisions. That meant that the listed plans in the public health insurance exchanges

I. Cannot deny health insurance to anyone with pre-existing conditions

II. Cannot charge higher premiums from those with pre-existing conditions

III. Should include certain minimum benefits such as:

    • Ambulatory care
    • Emergency services
    • Maternity and newborn care
    • Mental health and substance abuse services
    • Provide cover for hospitalization and surgeries
    • Preventive Care

How do International Students Benefit from Healthcare Marketplace?

Most US Universities have their own sponsored student health insurance plans. While some mandatory enroll students in their sponsored plans, others allow students to either purchase plans from private parties such as Student Cover or purchase them from ACA health insurance marketplace either run by the federal government or by the state.

There are over a dozen public health exchanges in different states and districts of US. The biggest public exchange is HealthCare.gov run by the federal government. It provides health insurance to Americans in 39 states.

Are all Plans the Same for Health Insurance Buyers?

Since healthcare marketplace is an exchange and not a seller of health insurance, the types of plans available to a person residing in a particular region differs. For example, if a person lives in the Arizona state, he or she might not be able to purchase plans that are not offered by health insurance providers for that particular state.
That is the reason why one has to mention the state or district that he or she currently resides in in the insurance exchange portal in order to get the plans applicable to his or her state.

Let’s Wrap Up

Health insurance exchanges are one-stop-shop for buyers of health insurance where they can explore, compare and select the health plans of their choice. The exchange themselves are not sellers of health insurance but provide a platform for insurance providers to list their plans for the public. The public health insurance exchanges require the listed plans to comply with ACA regulations.

Disclaimer: The content of the following article is based on the personal research of the writer. Readers are advised to exercise discretion. Student Cover will not be liable for any wrongful interpretation of the content of this article.

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