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Changes to How You Buy

Want to know more about the health reform law and what it means for people without employer-based health insurance? We’ll walk you through the basics of how Affordable Care Act (ACA) has changed the health insurance buying process, all in three steps:

  1. Changes to WHAT you buy
  2. Changes to HOW you buy
  3. Changes to WHEN you buy

If you’re uninsured or buy your own health insurance, the Affordable Care Act (ACA) gives you multiple ways to buy coverage that meets the minimum coverage standards of the law.

Option 1 - Enrollment through licensed private channels:

Under the ACA, consumers can buy health insurance from licensed agents, online or off, or direct from insurance companies. Private enrollment channels are typically staffed with licensed health insurance agents. The Augeo Benefits fits into this category.

Option 2 - Enrollment through government exchanges:

Under the ACA, consumers also have the option to purchase certain kinds of health insurance through government run “exchanges” or marketplaces. Some states have created their own exchanges while others use the federal government’s exchange. Exchanges are typically staffed with “Navigators.”

Plans Available

Below are the types of plans you can purchase through licensed private exchanges like Augeo Benefits versus through government exchanges:

Major Medical Plans
Licensed Agents: YES
Government Exchanges: NO 

Qualified Health Plans
Licensed Agents: YES
Government Exchanges: YES

Catastrophic Plans
Licensed Agents: YES
Government Exchanges: YES

Supplemental Plans
Licensed Agents: YES
Government Exchanges: Possibly

Gap (Short-Term) Plans
Licensed Agents: YES
Government Exchanges: Possibly

Conclusion: Augeo Benefits has more plans available than the government exchanges.


Licensed Agents VS. Exchange Navigators

How do the licensed agents stack up to Navigators in the government exchanges?

Cost you money to use one?
Licensed Agents: NO
Exchange Navigators: NO

Help you apply for a subsidy?
Licensed Agents: YES
Exchange Navigators: YES

Help you understand plans on a government exchange?
Licensed Agents: YES
Exchange Navigators: NO

Help you understand plans NOT on a government exchange?
Licensed Agents: YES
Exchange Navigators: NO

Recommend a plan based on your individual needs?
Licensed Agents: YES
Exchange Navigators: NO

Act as your advocate if you have a problem with your insurance company?
Licensed Agents: YES
Exchange Navigators: NO

Required to be licensed in your state?
Licensed Agents: YES
Exchange Navigators: NO (Some state require licensing)

Undergone criminal background checks?
Licensed Agents: YES
Exchange Navigators: NO

Passed strict insurance licensing exams?
Licensed Agents: YES
Exchange Navigators: NO

Payment

The ACA tries to reduce the amount of uncompensated care the average U.S. family pays for by requiring everyone to have health insurance or pay a tax penalty.

If you’re lower-income, you may be able to qualify for premium tax credits or subsidies that make insurance more affordable.


SOURCE: https://www.ehealthinsurance.com/resource-center/wp-content/uploads/3-steps-obamacare-ehealth-2016.pdf

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