Should You Accept Insurance Exchange Coverage?

Higher Deductibles

Another problem is the trend toward higher deductibles, which has only been exacerbated by the exchanges. Public exchange plan options are labeled platinum, gold, silver, bronze, or catastrophic to differentiate their levels of coverage, with platinum having the best coverage and highest premiums, and catastrophic the worst coverage and lowest premiums.¹⁰ In general, the worse the coverage, the higher the co-pay and deductible; the cheapest plans may have deductibles as high as $4000.¹¹ By requiring patients to authorize use of a credit card, physicians will be better equipped to deal with those with the cheaper plans and higher out-of-pocket costs.

Private Exchanges

To complicate matters further, there also are private exchanges, which are created by private sector companies and therefore are not part of the PPACA. They offer no government subsidies and no grace period. Employers looking for a lower-cost alternative to conventional private coverage may offer their employees a set amount of money for insurance and then direct them to a private exchange where employees can select various options based on the employer’s payment.

Conclusion

The overall effect of public and private exchanges on private practices and on the American economy in general may not be known for several years. A recent editorial in the Wall Street Journal suggested that the exchanges have already had a substantial negative influence on the gross domestic product.¹² Nonetheless, it is already clear that exchanges are going to change the way millions of Americans choose their health insurance and how they use their benefits. Private practitioners will have to monitor these changes closely in the coming years.