Q: How will the ACA’s health insurance exchanges interact with critical illness plans?
A: With the enactment of the Affordable Care Act (ACA) critical illness plans have become increasingly popular as a less expensive benefit offered by employers. In addition, with the increase in high-deductible health plans and health savings accounts, critical illness plans offer a valuable supplement. Critical illness plans will not be available through the state health insurance exchanges as they do not meet the definition of the essential benefits package.
Under critical illness plans benefits are paid directly to the patient if they are diagnosed with a coverable significant disease such as a stroke, heart attack, or cancer. Because employers can offer critical illness coverage with no employer contribution it is often an alternative sought by smaller businesses.
In 2014 with the implementation of the health insurance exchanges, critical illness coverage may also provide a supplement to consumers who are insured under the the health insurance exchange’s basic Bronze level plan which will cover the essential health benefits at 60 percent. Individuals on the bronze plan may consider supplemental critical illness plans as an inexpensive opportunity to fill gaps in their coverage.