Tips about the Health Insurance Marketplace®
If you don't have health insurance through a job,
A federal health insurance program for people 65 and older and certain younger people with disabilities. It also covers people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
Refer to glossary for more details.
,
Insurance program that provides free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Many states have expanded their Medicaid programs to cover all people below certain income levels.
Refer to glossary for more details.
, the
Insurance program that provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid but not enough to buy private insurance. In some states, CHIP covers pregnant women.
Refer to glossary for more details.
, or another source that provides
Any health insurance that meets the Affordable Care Act requirement for coverage. The fee for not having health insurance no longer applies. This means you no longer pay a tax penalty for not having health coverage.
Refer to glossary for more details.
, you can find coverage through the Marketplace.
1. Open Enrollment is November 1-January 15
- Enroll by December 15 for coverage that starts January 1
- Enroll by January 15 for coverage that starts February 1
2. Outside the yearly Open Enrollment, you can get coverage or change plans only if you:
- Have a life change or income that qualifies for a .
A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.
Refer to glossary for more details.
- Qualify for Medicaid or the Children's Health Insurance Program (CHIP). You can enroll any time of year and coverage can start immediately. Learn more about these programs.
Check if you qualify Preview plans
3. Most people qualify for savings
Depending on your expected household income for the year, you may qualify for:
- Lower costs for your Marketplace plan, like thethat lowers your monthly plan premium, and for
A tax credit you can use to lower your monthly insurance payment (called your “premium”) when you enroll in a plan through the Health Insurance Marketplace®. Your tax credit is based on the income estimate and household information you put on your Marketplace application.
Refer to glossary for more details.
on out-of-pocket costs likeA discount that lowers the amount you have to pay for deductibles, copayments, and coinsurance. In the Health Insurance Marketplace®, cost-sharing reductions are often called “extra savings.” If you qualify, you must enroll in a plan in the Silver category to get the extra savings.
Refer to glossary for more details.
,The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.
Refer to glossary for more details.
, andA fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible.
Refer to glossary for more details.
.The percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible.
Refer to glossary for more details.
- Coverage through Medicaid or CHIP. Your children may qualify for CHIP, even if you don't qualify for Medicaid.
See if you might save.
4. All Marketplace plans cover:
- 10 essential health benefits, including prescription drugs, emergency services, hospitalization, laboratory services, and mental health and substance use disorder services
- Free preventive health services at no cost to you when delivered by a doctor or provider in your plan's
The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services.
Refer to glossary for more details.
- Coverage for pre-existing conditions
5. You can apply for coverage several ways
Apply any way that works for you:
- Online
- By phone
- With the help of someone in your community
- Through an agent/ broker
- Through certified enrollment partner websites
- With a paper application
Apply now
Get details on ways to apply.
Use this checklist to gather what you’ll need to complete your application (PDF, 184 KB).
6. Don't forget to pay your monthly premium
When you have Marketplace insurance, you'll pay your monthly premiums directly to the insurance company — not to the Marketplace. Your coverage won't start until you pay your first premium. Get more information on completing your enrollment.
Notice:
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