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Federal regulations place guidelines on health insurance exchanges

Oct 19, 2013 - By Eric Blom, Staff Writer

Federal regulations have established guidelines for the health insurance exchanges, and consumers can apply and purchase health insurance through them completely online.

All policies sold on the exchanges must contain 10 essential components: emergency services, hospitalization, maternity and newborn care, mental health and substance abuse, prescription drugs, rehabilitation services and devices, laboratory services, and preventative wellness services. Plans also must cover chronic disease management, and insurers must accept people with pre-existing conditions.

The Affordable Care Act provides subsidies for people purchasing health care through the exchanges. Consumers earning up to 400 percent of the poverty level income can qualify for a federal subsidy to reduce the cost of health insurance purchased through the exchange, said Danielle Allred, a certified counselor with the Wyoming Health Council.

To start the process, a consumer should visit Healthcare.gov and create a profile. The website will first verify the person's identity, and then ask for more information, such as family size and income. Using the data, the website determines the consumer's eligibility for various health insurance plans and displays the options.

"This allows you to compare and contrast them all," Allred said.

Insurance plans are separated into five categories: bronze, silver, gold, platinum and catastrophic.

"Basically, the difference between the bronze and the platinum is your premium will be a little lower but you'll have a high deductible," Allred said. "With the platinum, your premium will be higher, but your deductible will be lower."

Only people under 30 years old or with low incomes can purchase for catastrophic plans. Those plans have low premiums but require individuals to pay for all medical expenses up to a certain amount, which is usually several thousand dollars.

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