What Is The Healthcare Exchange?

One of the factors that has many people confused about the Affordable Care Act is its healthcare exchange program.

What is the healthcare exchange? Who qualifies for it? How can I apply? What happens if I decline to apply? What research should be done beforehand? All of these questions have likely passed through the minds of many Queens residents about the legislation.

The most basic answer is that the healthcare exchange is an organization marketplace that allows consumers to compare insurance options and choose a plan to enroll in. In each state, the product’s name is different. In New York, the official name of the program is New York State of Health.

“The creation of the exchange was to afford healthcare coverage for those who are currently uninsured,” David Evangelista, director of managed care at Jamaica Hospital, said.

It applies to any U.S. citizen who does not qualify for Medicare or Medicaid. If you apply for either of those programs or you are an illegal immigrant or a non-resident, you do not qualify for the healthcare exchange.

The biggest benefit to enrolling with the program is the availability of care when it is needed. By enrolling, individuals will have access to a primary care physician and a hospital, all at a low cost.

The enrollment period will last until March 31, 2014 for the first year of the healthcare plan. Coverage will go live on Jan. 1.

There is a tax penalty for those who qualify and choose to opt out of enrollment. It will be $95 or one percent of your gross salary, whichever is higher. In subsequent years, the penalty will increase. But if you are not eligible for a tax return, then you will not be penalized.

The easiest way to apply for the plan is to visit nystateofhealth.ny.gov and sign up for the exchange. According to Evangelista, the process is similar to booking a vacation online.

“It’s very much like going to Travelocity. You’re going to put in what you’re looking for. It will ask some basic questions about yourself, your family size, your family income,” he said. “It will take you to a page that lists all the insurance and give you different purchasing options.”

There are also certified enrollment specialists who you can call if you do not have Internet access. To find the specialist for you, call the State’s health help line at (855) 355-5777 or visit the website.