Posted : 10/06/2011
Imagine walking into your corner drugstore to pick up aspirin, toothpaste and individual health insurance.
That day might not be so far away. Walgreens reportedly may enter the health insurance marketplace this fall, selling a variety of health plans at a variety of price points, although the company has not confirmed such reports.
Walgreens’ possible entrance into the health insurance market is a result of a health care reform legislation mandate that will establish health insurance exchanges to offer coverage options. The exchanges must be in place by Jan. 1, 2014.
If your employer doesn't offer health insurance, you'll be able to buy it directly for you and your family through an exchange. And if you're a small business owner, the exchanges are designed to give you a broader choice of health plans, at a lower price.
Companies such as retailers, financial services providers and others may now consider jumping into the health insurance business.
Ankeny Minoux, president of the nonprofit Foundation for Health Coverage Education, speculates that companies are holding off making announcements about plans to enter the health insurance arena because the formal rules under which they would operate haven't been established yet.
Under health reform guidelines, each state will be able to establish its own health insurance exchanges, or have the federal government do it for them.
Consumers will see some big changes when the exchanges roll out. One of them is that insurers won't be able to deny you coverage if you have a pre-existing condition.
That means people with a pre-existing condition "can shop the market and not just the high-risk [insurance] pool," Minoux says.
Another benefit will be tax credits to help you pay for insurance if your income is between 100 percent and 400 percent of the federal poverty line.
Because each state can set up its own exchange, it has certain powers to decide what it wants its exchange to look like, says Carla Saporta, health policy director at the Greenlining Institute, a public policy research and advocacy organization.
Companies that decide to sell health insurance nationwide theoretically could face 50 different sets of rules.
Saporta is based in California, which was the first state to adopt legislation creating a health exchange. Its board members are negotiating with health insurance providers "to keep costs down for consumers," she says.
The California exchange also will set up a website to provide consumers with comparison information on health plan options.
Jeff Gitlin, principal of PwC's U.S. health care payer practice, says insurers that participate in the exchanges must be consumer-friendly, because many insurance companies are accustomed to selling their plans to businesses rather than individuals.
Education is going to be crucial to make consumers "better informed decision-makers," Gitlin says.
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