Medigap refers to various private health insurance plans sold to supplement Medicare in the United States. Medigap insurance provides coverage for many of the co-pays and some of the co-insurance related to Medicare-covered hospital, skilled nursing facility, home health care, ambulance, durable medical equipment, and doctor charges. Medigap's name is derived from the notion that it exists to cover the difference or "gap" between the expenses reimbursed to providers by Medicare Parts A and B for the preceding named services and the total amount allowed to be charged for those services by the United States Centers for Medicare and Medicaid Services (CMS).
The Massachusetts health care reform, commonly referred to as Romneycare, was a healthcare reform law passed in 2006 and signed into law by Governor Mitt Romney with the aim of providing health insurance to nearly all of the residents of the Commonwealth of Massachusetts.
eHealth, Inc. dba eHealthInsurance is a private online marketplace for health insurance, organized in Delaware and based in Santa Clara, California. The company primarily provides plans related to Medicare such as prescription drug plans, Medigap, and Medicare Advantage plans. The company also sells individual plans, competing with health insurance marketplaces. The company sells plans in all 50 U.S. states and the District of Columbia from 170 health insurance carriers. Its large staff of licensed agents assist consumers with little or no computer experience with their online enrollments.
In the United States, health insurance marketplaces, also called health exchanges, are organizations in each state through which people can purchase health insurance. People can purchase health insurance that complies with the Patient Protection and Affordable Care Act at ACA health exchanges, where they can choose from a range of government-regulated and standardized health care plans offered by the insurers participating in the exchange.
Members of the United States population between the ages of 18 and 29 who decide that it is in their financial best interest to forgo health insurance are sometimes referred to as young invincibles by the insurance industry, a term coined to express the idea that the young demographic perceives themselves as immune to sickness and injury. The argument is that these individuals are young and in good health, so they have a low risk of experiencing substantial health issues that would lead to large amounts of spending on health care. Further, this group tends to have a mentality of “it won’t happen to me” with regards to most causes of injury. Together, these beliefs lead to the young invincibles not purchasing insurance.
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act, and commonly known as Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965.
Cover Oregon was the health insurance marketplace for the U.S. state of Oregon, established as Oregon's implementation of the Patient Protection and Affordable Care Act. Cover Oregon was intended to enable Oregonians and small businesses to purchase health insurance at federally subsidized rates.
Covered California is the health insurance marketplace in the U.S. state of California established under the federal Patient Protection and Affordable Care Act (ACA). The exchange enables eligible individuals and small businesses to purchase private health insurance coverage at federally subsidized rates. It is administered by an independent agency of the government of California.
Washington Healthplanfinder is one of the fourteen health insurance marketplaces in the United States and was created in accordance with the Patient Protection and Affordable Care Act, commonly referred to as Obamacare.
Connect for Health Colorado is the health insurance marketplace, previously known as health insurance exchange, in the U.S. state of Colorado, created in accordance with the Patient Protection and Affordable Care Act. It is located in Denver. The marketplace operates a toll-free call center and offers 541 health plans from 18 insurance companies.
HealthCare.gov is a health insurance exchange website operated under the United States federal government under the provisions of the Patient Protection and Affordable Care Act, which currently serves the residents of the U.S. states which have opted not to create their own state exchanges. The exchange facilitates the sale of private health insurance plans to residents of the United States and offers subsidies to those who earn between one and four times the federal poverty line, but not to those earning less than the federal poverty line. The website also assists those persons who are eligible to sign up for Medicaid, and has a separate marketplace for small businesses.
kynect, formerly and also called the Kentucky Health Benefit Exchange, is the health insurance marketplace, previously known as health insurance exchange, in the U.S. Commonwealth of Kentucky, created by then-Governor Steve Beshear in accordance with the Patient Protection and Affordable Care Act. Steve Beshear's successor as governor, Matt Bevin, ended Kynect enrollment for individuals as of 2017. From 2017-2020, the marketplace operated a web site for small business owners. Bevin's successor, Andy Beshear, announced on June 17, 2020 that Kentucky will reestablish a state health insurance marketplace similar to kynect, with full implementation by January 1, 2022. Kynect was officially relaunched on October 5, 2020 with full implementation expected by January 2022.
The Maryland Health Connection is the health insurance marketplace in the U.S. state of Maryland, created in accordance with the Patient Protection and Affordable Care Act.
Vermont Health Connect is the health insurance marketplace, previously known as health insurance exchange, in the U.S. state of Vermont, created in accordance with the Patient Protection and Affordable Care Act. The marketplace operates a web site.
Hawaii Health Connector was the health insurance marketplace, previously known as health insurance exchange, in the U.S. state of Hawaii, created in 2013 in accordance with the Patient Protection and Affordable Care Act. It was located in Honolulu. The marketplace operated a toll-free call center and offered 95 different health plans.
Patient navigators educate and assist United States citizens in enrolling into health benefit plans stipulated in the Patient Protection and Affordable Care Act (ACA). Patient navigators are also called "insurance navigators" or "in-person assisters" who have defined roles under the ACA. Although their roles might overlap, patient navigators are not community health workers or health advocates. "Navigators" work in states with Federally-Facilitated Exchanges (FFEs) or State Partnership Exchanges.
Health Republic Insurance of New York was a not-for-profit health insurance cooperative in New York State.
HealthSherpa is a California-based technology company focused on connecting individuals with health coverage. The site was initially developed as an alternative to research plans from Healthcare.gov. In 2020, the company had 3 core business units:
- Consumer. Shopping, quoting, enrollment and application & coverage management directly available to consumers to enroll in Affordable Care Act / "Obamacare" plans. Unique among for-profit enrollment sites, HealthSherpa.com shows all plans available from all insurers on equal footing without consideration of commission payments, and only offers ACA-compliant on-exchange coverage. HealthSherpa also partners with employers to help their non-benefits eligible employees find health coverage.
- Carriers. Enhanced Direct Enrollment platform leveraged by insurance issuers. As of 2019, 10 of 11 issuers approved for EDE used HealthSherpa's platform.
- Agencies and Brokers. A free enrollment pathway with integrated quoting, enrollment and servicing. More than 36,000 agents and 4,800 agencies have adopted HealthSherpa’s free agency and broker platform. HealthSherpa also offers a referral program where agents can refer non-appointed plans for a fee.
Enhanced Direct Enrollment (EDE) is a provision in the United States that allows certain private entities, including insurance carriers and web-brokers, to directly enroll consumers in Qualified Health Plans through the Health Insurance Marketplace without redirecting consumers to Healthcare.gov. Approved EDE partners may access a suite of APIs which allow them to directly submit and update applications on the federal exchange.
GoHealth is a marketplace for Medicare plans including Medicare Advantage, MediGap and Medicare Part D, which are programs administered through private health insurance companies. It also operates an online health insurance marketplace offering individual health insurance and short-term health insurance.
