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Marketplace Health Insurance

Individual plans regulated by the Federal government

Marketplace Insurance Plans

What are Marketplace Insurance Plans?

The Health Insurance Marketplace® is a service run by the federal government that helps people, families, and small businesses:

• Compare health insurance plans for coverage and affordability.

• Enroll in or change a health insurance plan.

• Find out about tax credits for private insurance or health programs like Medicaid or the Children’s Health Insurance Program (CHIP).

• Get answers to questions about health care insurance.

What are Marketplace Insurance Plans?

If you don't have health insurance through your job or other federal program, you can find coverage through the Marketplace. To be eligible for Marketplace coverage you must live in the United States, be a U.S. citizen or national (or be lawfully present), and not be incarcerated.

What do Marketplace Insurance Plans cover?

ALL marketplace plans provide the same coverage, regardless of carrier. Health benefits include prescription drug coverage, emergency services, hospitalization, laboratory services, and mental health and substance use disorder services. They also include free preventive health services.

When can you enroll in a Marketplace Insurance Plan?

November 1: Open Enrollment starts — first day you can enroll in, renew, or change health plans through the Marketplace for the coming year. Coverage can start as soon as January 1.

December 15: Last day to enroll in or change plans for coverage to start January 1.

January 1: Coverage starts for those who enroll in or change plans by December 15 and pay their first premium.

January 15: Open Enrollment ends — last day to enroll in or change Marketplace health plans for the year. After this date, you can enroll in or change plans only if you qualify for a Special Enrollment Period.

February 1: Coverage starts for those who enroll in or change plans December 16 through January 15 and pay their first premium.

How to choose a Marketplace Insurance Plan

Choosing a health insurance plan can be complicated. Knowing just a few things before you compare plans can make it simpler.

There are 4 categories of health insurance plans: Bronze, Silver, Gold, and Platinum. These categories show how you and your plan share costs. Plan categories have nothing to do with quality of care.

It's important to consider all the costs when comparing the costs of different plans. In addition to your monthly premiums also look at your out-of-pocket costs such as deductibles and co-pays.

Choose a network type that works best for you - HMO, PPO, POS, and EPO. There differences in these plans have to do with which doctors and health care facilities are covered under the plan. Some plans may let you go wherever you want and others limit your choices or charge you more if you use providers outside their network.