The Health Insurance Marketplace helps uninsured people find health coverage. When you fill out the Marketplace application online the website will tell you if you qualify for:
If you are eligible for job-based insurance, you can consider switching to a Marketplace plan, but you will not qualify for lower costs based on your income unless the job-based insurance is unaffordable or does not meet minimum requirements. You also may lose any contribution your employer makes to your premiums.
All private health insurance plans offered in the Marketplace offer the same set of essential health benefits. The essential health benefits include at least the following items and services.
Essential health benefits are minimum requirements for all Marketplace plans. Specific services covered in each broad benefit category can vary based on your state’s requirements. Plans may offer additional benefits that are not included in essential health benefits, such as dental and vision coverage.
Benefits are generally the same in each state. However, some states require insurers to cover additional services and procedures. When you compare plans in the Marketplace, you will be able to see the specific benefits each plan offers.
An open enrollment period is a yearly time when you can enroll in a health insurance plan. The open enrollment period is generally November 1 through December 15. Some states have longer open enrollment periods that start sooner and/or end later.
Outside the open enrollment period, you can only enroll in or change a Marketplace plan if you have a life event that qualifies you for a Special Enrollment Period. You may qualify for special enrollment if you or anyone in your household in the past 60 days:
Note: There is no limited enrollment period for Medicaid or CHIP. If you qualify, coverage can begin immediately.
Most states do not have their own Marketplace. Individuals in those states can use HealthCare.gov to apply for and enroll in health coverage online. If you live in a state that operates its own Marketplace, you will go to your state’s Marketplace website to apply and enroll. See the following chart.
DISCLAIMER: This article contains general information for U.S. taxpayers and should not be relied upon as the only source of authority. Seek out professional tax, legal, or financial advice from CryptoTaxAudit or from other reputable companies.