Health Insurance Exchanges
Exchanges at a Glance Exchange FAQs
The Affordable Care Act (ACA) created guidelines for a new kind of marketplace for health insurance. Learn more about exchanges and how Aetna supports them.
What are exchanges?
Exchanges (also called "marketplaces") are online markets where consumers and small businesses can go to shop for health insurance. On these sites, they can compare the available plans and then purchase online.
Exchange Frequently Asked Questions (FAQs)
Who creates and maintains the exchanges?
- Each state has the option to create and operate its own exchange.
- If the state decides not to create its own exchange, the federal government will administer the exchange in that state.
- Outside of the government, private exchanges may also exist.
Who can shop on an exchange?
Starting on October 1, 2013, the federal and state-based exchanges, for those states that choose to participate, will be available for small employers and individuals shopping for health insurance. Visit our exchange timeline to learn more about other dates key to the development and operation of exchanges.
Do exchanges help address the cost of health insurance?
For individuals who meet certain criteria, two new elements can help make health insurance affordable for them:
What kinds of plans will be available on an exchange?
To participate on an exchange, health plans will need to meet specific criteria. Here are the basics:
Where can I go to learn more about my state’s exchange?
To find out what your state has, you can visit Healthcare.gov. You will find links to the state-specific exchange websites.
I’ve never had insurance; how do I know what plan I should pick?
Your state exchange/marketplace will have people, called Navigators, who are there to help walk you through the shopping process. They can help you compare plans and ask questions to help you find the right fit for you.
When can I enroll in a plan on the exchange?
Enrollment on public exchanges begins October 1, 2013, for coverage that will be effective January 1, 2014 or later depending on enrollment and payment by the consumer. For this first year, open enrollment is between October 1, 2013 and March 31, 2014.
What will your plans on exchange cover?
All of our Aetna plans will comply with the new ACA requirements for 2014. Any benefits package sold on or off of an exchange to individuals and small group employees must include coverage for what are called “essential health benefits .”
What do the metallic levels on an exchange mean?
To help make shopping easier, health plans on a public exchange will be labeled platinum, gold, silver or bronze. The metallic level helps shoppers understand the level of coverage a plan offers – how much they will need to pay and what the plan pays.
Platinum plans will typically mean that you will pay less for medical services, but your monthly premium will be higher. With a Bronze plan, on the other hand, you will typically pay more for medical services, but your monthly premium will be lower.
See health plan categories to learn more.
Am I eligible for financial aid on an exchange?
The ACA will provide premium tax credits and subsidies for individuals who qualify, to help make insurance more affordable, when they shop on a public exchange.
You will be able to determine if you are eligible when you shop on the exchange. The exchange will ask you for information about your income level and then let you know what financial assistance you may qualify for.
How do I know if my doctor will participate in a plan sold on an exchange?
You will be able to link to an online provider directory while you are shopping on the exchange, to see which providers are in each carrier’s network and plan.
I have insurance through my employer. Can I still shop for a plan on an exchange?
Yes. However, if your employer is offering you coverage, you may not qualify for financial assistance. The exchange can help you understand if you qualify.
For definitions of these and other exchange-related terms, visit our exchange glossary page.
How do I know if I don’t qualify for financial assistance on the exchange because of the insurance my employer offers?
Your employer is required to send you a letter that lets you know that public exchanges will be available as of October 1, 2013, and if the coverage they offer meets the standards set by the ACA. If their coverage does meet those standards, then you are probably not eligible for financial assistance on the public exchange. However, you can contact the exchange in your state to learn more.
Additional resources:
- Exchange timeline
- Exchange status by state (Source: Kaiser Family Foundation)
- Glossary of terms
- Healthcare.gov
