Help Customers Understand the Marketplace
WHAT ARE HEALTH INSURANCE MARKETPLACES?
Organizations that are set up to aid uninsured Americans in purchasing health insurance in accordance with the Affordable Care Act (ACA). When coverage is purchased through these marketplaces, individuals can receive tax credits. Each state has control in shaping health care reform for its residents and can choose to create and operate its own exchange; partner with other state exchanges; or opt not to create an exchange and instead have the federal government create an exchange for them.1
WHO IS ELIGIBLE?
- Americans whose income is up to 400% over the Federal Poverty Line (roughly $43,320 for an individual or $88,200 for a family of four).
- Small businesses with 100 workers or fewer
HOW RETAIL PHARMACIES CAN HELP
Your pharmacy can play an important role in educating and enrolling your existing and prospective patients. Here's how:
| The Steps | The Details |
|---|---|
| 1. Get educated. | The insurance landscape is complex, but helping customers understand, in basic terms, what they need to do can provide great value. Carve out some time to understand what's happening. |
| 2. Understand your state's specific situation. | The landscape and specifics are different in each state. Be able to explain to your customers how the exchange in your state works and exactly what customers need to do. Here are resources to help explore state-specific marketplace activities:
|
| 3. Have information and resources. | Make information available to your customers in your store and on your website.
|
| 4. Be proactive. | Don't just wait for customers to ask you questions. Instead, identify customers who are paying for prescriptions with cash and insert a bag stuffer. Or even better, consider gently asking if they might be interested in knowing more about insurance options. |
| 5. Get formal. | Consider more official ways to educate your community about their options:
|
FOR MORE INFORMATION
Check out the Related Documents on the right side of this page.
REFERENCES
1. WebMD. Insurance Marketplaces: What Your State Decides. Reviewed by David Howard, PhD May 13, 2013.
2. Smart Retailing Rx. Educating Customers About Health Insurance. September 2013. Accessed 9/13/13.
