Affordable Care Act: 2017 Changes On Marketplace Coverage

Affordable Care Act: 2017 Changes On Marketplace Coverage

The Obama administration has made a number of recent changes to the Affordable Care Act which is meant to deal with some of the challenges which are associated with it. A number of people have had difficulty interpreting the networks, coverage and fees which pertain to ACA, and this has made it difficult for them to make informed decisions. Get to know three major adjustments which will go into effect in 2017:

A Reduction In Unexpected Medical Bills

Many patients have complained about receiving unexpected medical bills from healthcare providers that are out of network. This is frustrating and confusing to many patients as they thought these providers were in-network. No one likes receiving unexpected bills, and as a result a change has been made to ACA which is meant to reduce the appearance of these notices.

Under this new arrangement any fees which are paid by patients for care which is ancillary, such as radiology must be relegated to the patient’s yearly maximum out of pocket expense. This is critical because after a patient reaches their maximum out of pocket expense insurers must handle all the medical costs which are in-network for the remainder of the year. However, this change has a stipulation where it only applies to situations where insurers have not provided patients with the required notice that they could receive bills from providers which are out of network.

Provides Greater Access To Insurer’s Network of Hospitals and Doctors

When choosing a medical plan, the majority of customers will focus mainly on the price of the plan and whether their hospital or physician is included within the network associated with it. However, finding accurate data regarding this has been extremely challenging, leading to complaints. Two new adjustments have been made to Obamacare which are meant to address this problem.

First, the Marketplace must notify consumers of the size of each network associated with each plan, breaking them down into three categories which are broad, standard or basic. Second, it will become mandatory for insurers to provide customers with a 30 day notice whenever a provider is taken out of a network, and they must continue offering coverage for the provider for as long as 90 days for patients who are actively receiving treatment.

Out Of Pocket Fees Will Be Standardized

The final change to ACA involves the standardization of fees which are paid out of pocket, which will make it easier for consumers to compare and shop for the best options. Insurers have been asked to provide plans that have a standard range of coverage fees, such as co-payments and deductibles. The purpose of doing this is to assist customers in understanding the fees that they will have to pay themselves. Some states have already enacted standardized fees, but because it is voluntary compliance within other states is not certain.

These changes are designed to streamline the process involved with purchasing health coverage as well as allowing consumers to make educated decisions which will assist them in getting the healthcare they need and deserve.