Maryland will contract with certain entities who will then hire individual navigators. Those navigators will not be employees of the exchange. The aim is to have a full cadre of navigators by late spring and to have them completely trained by late summer, said Danielle Davis, director of communications and outreach for the Maryland Health Connection.
What Will Plans Look Like in Maryland?
The ACA requires each state health insurance exchange to establish an essential benefits package; every plan for sale in the exchange must offer these benefits. In Maryland, plans must offer:
• Ambulatory services.
• Emergency services.
• Hospitalization.
• Maternity and newborn care.
• Mental health and substance use disorder services.
• Prescription drugs.
• Rehabilitative and habilitative services and devices.
• Laboratory services.
• Preventive and wellness services and chronic disease management.
• Pediatric services, including oral and vision care.
Each state exchange must choose a benchmark plan that covers the essential benefits; insurance carriers build upon that plan. Maryland chose its state employees’ health benefits plan as its benchmark.
So far, all 12 insurers in Maryland’s small group and individual markets have indicated they want to participate in the exchange, Ms. Pearce said. Consumers can begin enrolling on Oct. 1, 2013; coverage starts on Jan. 1, 2014.
For physicians, the transition should be seamless, said Ms. Pearce. Patients who gain coverage through the exchange will have benefits and identification cards from insurance carriers, just like every insured patient.