Health Insurance Marketplaces

COVID-19 Updates:

• HealthCare.gov is open for enrollment until August 15, 2021 for coverage in 2021.

Due to the Affordable Care Act (ACA), taxpayers who don’t have health insurance through group plans (like from an employer) or individual coverage can get healthcare through the government-run Health Insurance Marketplace.

Besides being a hub for shopping for and buying insurance, marketplaces can help you find subsidies and other ways to help you pay for insurance. If you’re eligible, the marketplace will help you find coverage through Medicaid, Children’s Health Insurance Program (CHIP), and other health benefit programs.

How do I access the Health Insurance Marketplace?

To access the Marketplace, you will either use your state marketplace or the federal one at HeathCare.gov, depending on which state you live in.

Check if your state has its own marketplace. If not, apply through HealthCare.gov.

Can I get help paying for my health insurance?

The main purpose of the government-run Exchange is to ensure that everyone has access to affordable insurance, regardless of income. However, if you’re hoping to use the Premium Tax Credit (PTC) to help pay for insurance, you must buy your insurance through the government marketplace.

When can I enroll in healthcare coverage?

Typically, you can only sign up during open enrollment, which typically runs from November 1 to December 15.

In special enrollment periods or after major life events, however, you can enroll outside the typical six-week window. See HealthCare.gov for a full list of qualifying circumstances and special enrollment periods.

Watch out for scammers posing as healthcare advisors

Specially trained Navigators can help you find coverage on HealthCare.gov. They’re there to help educate you about the plans available, but they are required to be unbiased, and their advice is free.

If anyone asks you to pay for helping you select insurance, it’s probably a scam.

What kind of coverage can I get on the Health Insurance Marketplace?

There are four levels of plans available through the marketplaces: Bronze, Silver, Gold, and Platinum. Each has different levels of premiums and deductibles, and each is designed to meet different healthcare needs. Not everyone benefits most from the “Platinum” level, even though it sounds like “the best.”

There is also the catastrophic plan category. It’s the least expensive option, offering essential health benefits, but with high deductibles.

Catastrophic plans are pretty bare, so they’re not available to just anyone. If you’re younger than 30 or exempted by financial hardship from carrying the minimum health insurance coverage, you’re eligible for a catastrophic plan.

To see a breakdown of the plans and determine which is best for you, check out HealthCare.gov’s page on how to pick an insurance plan.

Do I have to take the insurance my employer offers?

No, you can choose to use the Marketplace instead of your employer-sponsored health coverage. However, you likely won’t qualify for financial aid on the Marketplace if you have access to affordable employer insurance.

If you have Marketplace insurance and get the Premium Tax Credit, a new offer of employer insurance could disqualify you from the Premium Tax Credit, even if you don’t take the offer. See HealthCare.gov for more details.