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Sunday, September 22, 2013

Tennessee Health Insurance Exchange Coverage

October 1st is less than two weeks away, and on that date adult U.S. citizens will be able to purchase health insurance from the Insurance Exchanges set up under the Affordable Care Act.  If you live in Tennessee, however, it can be confusing as to how you enroll.  Here is a quick primer.

Tennessee, like most Republican-led states, opted not to participate in the Exchange program.  There is no financial advantage to non-participation; actually not participating costs the state more money in the long run.  However the "anti-Obamacare" fever whipped up by Fox News and conservative talk radio made state participation tantamount to support of Healthcare Reform.  No Republican can survive a primary election if they are seen as supporting "Obamacare".  Instead these states, Tennessee among them, choose non-participation, which then requires the federal government to set up an Exchange for them.

Since Tennesseans have to use the federal Exchange program let's look at how you do that.

The federal program is called the Insurance Marketplace and enrollment is done on-line.  If you try to Google "Tennessee Insurance Exchange" or something similar you will get a page telling you that there is no state Exchange in Tennessee.  It is unhelpful in that it does not provide you with a link to the federal site so I am not linking to it here.

As of today you cannot yet get information from the Insurance Marketplace site regarding plans and premiums.  Those are coming October 1st.  You can roam the site and get a list of local offices where you can get one-on-one help in reviewing plans and enrolling.

Finally let's take a quick look at who should, and should not, be concerned about enrollment in the Insurance Marketplace.

  • If you have health coverage through your employer and are satisfied with it then you do nothing.
  • If you are covered by benefits through the government, a retirement plan, or the military you should do nothing.
  • If you have health insurance coverage offered through your employer but can't afford it you should look into Insurance Marketplace coverage.  You may qualify, based upon income, for a tax subsidy either instantly or at tax refund time.
  • If your employer does not offer health coverage then the Insurance Marketplace is for you.
  • If you are self-employed and have no coverage, or your coverage is expensive, the Insurance Marketplace is for you.
  • If you or a dependent have a pre-existing condition and have not been able to get coverage in the past, the Insurance Marketplace has guaranteed-issue coverage with no pre-existing exclusions.

Most of the people who are critical and/or screaming about this program are not affected by it.  There are even conservative groups in some markets trying to discourage uninsured people from enrolling.  Don't get sucked up into the political and philosophical hype: we are all paying for the Affordable Care Act so that 30 million uninsured Americans can have coverage.  If you are one of them go enroll.

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