Consumers should expect professionalism in the Marketplace

There are procedures and privacy standards that organizations must follow when assisting consumers to purchase health insurance in the Marketplace.

The Affordable Care Act (ACA) is designed to provide access to health insurance via the newly created health insurance Marketplace as well as expanded access to Medicare and Medicaid. The ACA has also been a source of controversy and confusion. Michigan State University Extension says that research shows many consumers are confused about how to purchase and use health insurance.

Let’s take a look at one of the terms associated with the Marketplace. One important term to know is Consumer Assistance Entity. These are individuals or organizations that are trained, certified and able to provide help to consumers, small businesses and their employees as they look for health insurance coverage on the Federal Health Insurance Marketplace (also called the Exchange). The different types of Consumer Assistance Entities are Navigators, Non-Navigator Assistance Personnel, Certified Application Counselors (CACs), agents and brokers.

If you are visiting with a CAC to help you purchase health insurance through the Marketplace you should be greeted and then asked about your level of knowledge of health insurance, the Affordable Care Act and the Marketplace.  You might hear questions such as Do you know the Marketplace is a place you can shop and compare plans that best meet your budget and specific health care needs?

Once the Counselor knows a bit about you, they should then ask you about your health insurance needs. CACs should focus on things such as your ability to afford health insurance coverage, your health care needs such as any current health conditions that you are currently receiving care for and your desire to see certain doctors or utilize doctors and hospitals in a certain location or network. They also need to assess if you currently have health coverage, whom in your household needs coverage and if you have started the eligibility application process in the Marketplace.

By this time the CAC should be able to help you create a plan for the next steps you will need to take to get health insurance coverage. If you request that the CAC help you begin online enrollment in the Marketplace, it’s important to know that he/she is not supposed to enter any of your personal identifying information and are not to keep original or copies of any documents that show your personal information, including Federal Tax Information, bank statements or other personal documents after your appointment as finished. “Personal information” includes things such as your name, Social security number, date and place of birth, your mother’s maiden name, documents that contain your finger prints, medical, educational, financial and employment information, your phone number, address and Driver’s license.

For more information about the Marketplace, visit www.healthcare.gov and click on the “Learn” tab at the top of the page. You can also visit www.aca.msue.msu.edu for information about educational opportunities focused on choosing health insurance that best meets your needs. 

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