If you are uninsured, self-employed, or do not have access to affordable health insurance through your job, you can enroll in the Health Insurance Marketplace.
What is the Health Insurance Marketplace?
The Health Insurance Marketplace (also known as Marketplace) is a website (healthcare.gov) where you can shop for health insurance plans. The plans you see on the Marketplace website are owned and operated by insurance companies, not the Marketplace. The Affordable Care Act (also known as Obamacare or ACA) created the Marketplace as a way to buy health insurance.
The Marketplace is similar to an online travel service, such as Expedia.com. How? It lets you:
- Shop for and compare health insurance plans.
- Estimate the cost of health insurance plans.
- See if you can get help paying for health insurance.
- Buy a health plan for you and your family.
Can I use the Marketplace?
Yes! Anyone can use the Marketplace to see their insurance options. It is designed to help individuals and families get affordable health coverage.
You need to enroll or re-enroll each year during open enrollment. Open enrollment is a time period when you can enroll in or change a health insurance plan. Find dates for open enrollment at healthcare.gov. Open enrollment usually happens from November 1 to December 15 of each year and plans start coverage on January 1.
However, if you experience a major life change outside of open enrollment, you may get a Special Enrollment Period to enroll in Marketplace coverage.
When can I enroll in a Marketplace plan?
You need to enroll or re-enroll each year during open enrollment. Open enrollment is a time period when you can enroll in or change a health insurance plan. Find dates for open enrollment at healthcare.gov. Open enrollment usually happens from November 1 to December 15 of each year and plans start coverage on January 1.
However, if you experience a major life change outside of open enrollment, you may get a Special Enrollment Period to enroll in Marketplace coverage.
What do I need to sign up in a Marketplace plan?
To complete an application, you need to give information about yourself and your family, including:
It will also be helpful to have this information:
- Any health insurance you currently have. If you don’t have any, that’s okay.
- Number of people in your family.
- Information about anyone else in your household that has a job.
- Your total household income.
What are my plan choices in the Marketplace?
Insurance plans fall into 4 categories based on how the costs of care are shared between you and the insurance company. All plans will cover the same 10 essential health benefits, including yearly doctor visits, trips to the emergency room, and prescription medicines. The 4 plan categories are:
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- Bronze.
- Silver.
- Gold.
- Platinum.
Each health plan may have different costs, even if they are in the same category. When you shop for plans, you’ll see the available plans and costs in your area.
When comparing plans, there are 4 important things to look at:
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- The services that each plan covers, like doctor visits and medicine.
- How much you’ll pay for the plan each month, called premiums.
- How much you’ll pay out of your own pocket for health care each year, called your .
- How much you’ll pay out of your own pocket for health care after you pay your deductible, called cost-sharing or .
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The Marketplace also offers “catastrophic” plans. This is an insurance plan in the Marketplace that offers limited coverage for health care services. This plan is only available to adults under age 30 or adults without other reasonably priced coverage options. A catastrophic plan:
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- Protects you from very high medical costs only if you need a lot of care, like after a serious car accident.
- Has a lower premium but generally requires that you pay all your health care costs up to a certain amount – usually several thousand dollars.
- Only pays for essential health benefits after you meet the deductible.
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For more tips and questions to ask to compare plans, click here to find a handout on the Resources page.
Click here to visit healthcare.gov and compare plans and their prices.
Deductible
The amount you must pay for your covered health care services each year – for example, $1,000 – before your insurance plan will begin sharing the cost with you (see “coinsurance”).
Coinsurance
Your share of the cost for health care services, after you have paid your deductible amount each year. For example, if you go for a doctor visit that costs $100, your share may be $20 and your insurance plan’s share may be the remaining $80.