For many Americans living with diabetes, this day marked the first time they can remember having the chance to explore plan options, sign up for health insurance coverage, and not be discriminated against based on their pre-existing condition.
For more than 20 years, I have been an active volunteer with the American Diabetes Association. I advocate for people with diabetes, through raising awareness, raising funds for prevention and treatment and educating policymakers from the Ohio statehouse to Capitol Hill, to ensure diabetes is a priority on the local and national level. While there is always more work to be done, collectively our efforts have led us to this critical milestone, where access to adequate and affordable health insurance for people with diabetes is finally a real and possible option.
To keep you informed I’ve shared some general information below about the new Marketplaces, but be sure to read and share the Associations comprehensive Health Insurance Marketplaces and Health Insurance Updates resources available on diabetes.org. For assistance in selecting and enrolling in health insurance plans offered in the Marketplaces, visit healthcare.gov or call 1-800-318-2596.
What is a Health Insurance Marketplace?
A Health Insurance Marketplace is a new way individuals, families, and small businesses can shop for – and compare – various private health insurance options all in one place. Plans must meet certain requirements for benefits, consumer protections and cost to the consumer.
Marketplace plans are separated into four different categories: Bronze, Silver, Gold, and Platinum. These categories are based on an average of how much the plan pays for covered benefits. In general, moving from Bronze to Platinum, out of pocket costs get lower while premiums tend to get higher.
Who Can Buy Health Coverage in a Marketplace?
Generally, anyone who buys health insurance on their own can buy it through a Marketplace. However, only those who meet certain income requirements – and who do not qualify for affordable job-based health coverage or certain other types of coverage – are able to get financial help paying for a plan purchased in the Marketplace.
Can I Be Turned Down or Charged More for Coverage Because I Have Diabetes?
No. Starting in 2014, all new health insurance plans, whether sold inside and outside the Marketplace, cannot deny coverage, charge more, or refuse to cover treatments because you or someone in your family has diabetes.
What If I Already Have Health Insurance?
If you like your current insurance you can keep it, but check to make sure it meets minimum requirements to avoid the tax penalty for not having insurance coverage beginning in 2014.
The Marketplaces will be a new way to get health insurance, including insurance for people with diabetes who previously had trouble obtaining affordable health insurance that meets their needs. Learn More!
Gina Gavlak, RN, BSN, is Chair of the National Advocacy Committee, American Diabetes Association.