HHS Finalizes Policies to Improve Marketplace Coverage
- Author: Wilbert Raynor
- Posted: 2024-11-19
These rules will introduce coverage for routine dental benefits, broaden requirements to ensure reliable access to healthcare providers and ensure that individuals with lower incomes can enroll in coverage when they need it.
The aim is to improve access to affordable healthcare and raise quality standards for Marketplace plans nationwide.
HHS Secretary Xavier Becerra highlighted the success of over 21 million Americans signing up for high-quality, affordable healthcare coverage through the ACA Marketplaces in 2024.
'We want to build on this success to make Marketplace plans even better’, a quote from Secretary Becerra through the HHS Website.
He emphasized the administration's commitment to enhancing these plans.
Here's what you need to know:
Adult Dental Services: CMS has expanded access to dental benefits, allowing states to include routine adult dental services as an essential health benefit (EHB). These services, like cleanings and fillings, will be available in every state starting January 1, 2027.
Network Adequacy: The final rule sets consistent nationwide standards for how far and how long consumers must travel to see different types of healthcare providers in Marketplaces. This ensures that plans meet quality standards no matter where you are.
Special Enrollment Periods: The rule extends the special enrollment period for low-income households to enroll in coverage at any time, not just during Open Enrollment. It also aligns Open Enrollment periods across Marketplaces, generally running from November 1 to January 15, with the option to extend.
Streamlining Enrollment: The rule standardizes operations across Marketplaces to make it easier for consumers. This includes live call center support, a consistent Open Enrollment period, and automatic re-enrollment in catastrophic plans to prevent coverage gaps.
These policies reflect the commitment of the Biden-Harris administration to improve healthcare access and affordability for all Americans.
By strengthening the marketplace and expanding essential health benefits, the HHS is working to ensure that everyone has access to quality healthcare coverage when they need it most.
Overall, these policies represent a positive step forward in the ongoing efforts to enhance healthcare in the United States.
They provide greater options, expanded benefits, and increased affordability for individuals and families seeking coverage through the marketplace.
Did you read this the first time and get curious about the marketplace they are talking about? We got you!
You can find the marketplace mentioned multiple times above on the official website of the Health Insurance Marketplace, which is managed by the Centers for Medicare & Medicaid Services (CMS).
This website is commonly referred to as Healthcare.gov.
