Here’s a quick rundown on the most important things to know about the Health Insurance Marketplace, sometimes known as the health insurance “exchange.” Follow the links for more information on each topic.
The Health Insurance Marketplace helps uninsured people find health coverage. You may qualify for:
- Private health insurance. Plans cover essential health benefits, pre-existing conditions, and preventive care.
- Lower costs based on your household size and income. You can preview plans available in your area right now, with prices based on your income and household size. Most people who apply will qualify for lower costs.
- Medicaid and the Children’s Health Insurance Program (CHIP). These programs cover millions of families with limited income. If it looks like you qualify, your information will be shared with your state agency and they’ll contact you. Many but not all states are expanding Medicaid in 2014 to cover more people. Find out what Medicaid expansion means for you.
Most people must have health coverage in 2014 or pay a penalty. If you don’t have coverage, you’ll pay a penalty of either 1% of your income, or $95 per adult ($47.50 per child), whichever is higher. You’ll pay the penalty on your 2015 income taxes.
Marketplace open enrollment ends March 31, 2014. The proposed open enrollment period for 2015 coverage is from November 15, 2014 to January 15, 2015.
If you don’t enroll by March 31, 2014, you can’t get private health insurance inside the Marketplace until the next open enrollment period starts. If you’re uninsured you may be subject to the penalty for all of 2014. You can buy a health plan outside Open Enrollment if you qualify for a special enrollment period..
Ready to apply? Use this checklist to gather items you’ll need when applying for coverage.
Start your application now. Enroll by the 15th of the month and your coverage starts as soon as the 1st of the next month.
Some people qualify for an exemption to the penalty, based on income or other factors. If you enroll by March 31, 2014, you won’t have to pay the penalty for any month of 2014.
You’re considered covered if you have Medicare, Medicaid, CHIP, any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE, VA health coverage, or some other kinds of health coverage.
If you’re eligible for job-based insurance, you can consider switching to a Marketplace plan. But you won’t qualify for lower costs based on your income unless the job-based insurance isn’t considered affordable or doesn’t meet minimum requirements.
If you have Medicare, you’re considered covered and don’t have to make any changes. If you have Medicare, you can’t use the Marketplace to buy a supplemental plan or dental plan.
Questions? Call 24 hours a day, 7 days a week: 1-800-318-2596 (TTY: 1-855-889-4325)