5 tips about the Health Insurance Marketplace
If you haven’t applied for insurance on HealthCare.gov before, here’s what you need to know about the Health Insurance Marketplace (sometimes known as the health insurance “exchange” or “Obamacare exchange”).
1. The Health Insurance Marketplace is for people who don’t have health coverage
If you don’t have health insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying coverage, the Marketplace can help you get covered.
- If you have job-based insurance: You can buy a plan through the Marketplace, but you’ll pay full price unless your employer’s insurance doesn’t meet certain standards. Most job-based plans do meet the standards.
- If you have Medicare: You can’t switch to Marketplace insurance, supplement your coverage with a Marketplace plan, or buy a Marketplace dental plan. Learn about Medicare and the Marketplace.
2. What you pay for insurance depends on your income – and you’ll probably save
Your savings depend on your estimate of your expected income for 2016, not your income for 2015. This year, about 8 in 10 of the uninsured who are eligible for Marketplace coverage qualify for financial assistance to lower the cost of their monthly premiums. Get a quick idea if your expected income is in the range to save.
Based on the income estimate you put on your application, we’ll tell you if you qualify for one of these:
A health insurance plan with savings
Most people who apply qualify for a premium tax credit that lowers their monthly insurance bill. Some also save on out-of-pocket costs like deductibles and copayments.
The plans are offered by private insurance companies with a range of prices and features. All plans cover:
- Essential health benefits
- Pre-existing conditions, including pregnancy
- Preventive care
You can add dental to a health plan, but you don’t have to. You can’t buy a dental plan unless you enroll in a health plan.
Medicaid and the Children’s Health Insurance Program (CHIP)
Medicaid and CHIP provide free or low-cost coverage to millions of people and families with limited income, disabilities, and some other situations.
- Many states are expanding Medicaid to cover all households below certain incomes. See if your state is expanding and if your income is in range to qualify.
- Your children may qualify for CHIP even if you don’t qualify for Medicaid.
3. You can apply for coverage 4 ways
You can apply for health insurance any way that works for you:
- Online
- By phone
- With in-person help
- With a paper application
4. If you don’t have health insurance, you may have to pay a fee
Most people must have qualifying health coverage or pay a fee with their 2016 federal taxes.
- If you don’t have coverage in 2016, you’ll pay a penalty of either 2.5% of your income, or $695 per adult ($347.50 per child) — whichever is higher. Learn about the fee.
- In some cases, you might qualify for an exemption from the requirement to have health insurance.
5. Apply now. Act by December 15 for coverage starting January 1, 2016
You can apply right now. Enroll by December 15 and your coverage can start January 1, 2016. After January 31, 2016, you can’t buy a health insurance plan for the rest of 2016 unless you have a life change — like having a baby, getting married, or losing other health coverage — that qualifies you for a Special Enrollment Period.
This information was originally published on HealthCare.gov.