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2023: Marketplace Changes

2023: Marketplace Changes

Big changes coming to marketplace insurance plans in 2023!

Changes in 2023

The goal of the changes in marketplace plans in 2023 is to improve and simplify. There is a wealth of information on healthcare.gov. Unfortunately, so much info can be overwhelming. Many people find it extremely difficult to compare different health plans.

Standardizing Plans

There are so many options to choose from that it can make your head spin. This new initiative plans to standardize many plan features. This includes out-of-pocket max, deductibles, and cost-sharing features. With these factors a little more equal, it will be much easier to compare premiums, provider networks, prescription drug coverage, and quality ratings. 

Addionally, as it stands, there are a limited amount of services which are covered prior to meeting your deductible. In 2023, more services will be offered prior to meeting the plan’s deductible. There will also be simpler cost sharing structure. Hopefully this will be easier to understand.

Network Adequacy

Your plan may look good on paper, but it will be next to useless if you can’t get an appointment easily. That is also set to change in 2023. All Qualified Health plans available on the marketplace must ensure that there are PCPs located within 10 min or 5 miles in metro areas. Information on additional specialists is being reviewed, but OB/GYNs will fall under primary care regulations. 

This is all great news. Unfortunately, the larger premium tax credits under the American Rescue Plan Act still hang in the balance. After 2022, the much larger premium tax credits which were available are set to expire. This also means that many who were eligible for a premium tax credit under the American Rescue Plan Act would no longer be eligible. There is still a possibility that this may be extended for a period of time or possibly indefinitely.

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