Health Insurance Marketplace

How to navigate the Marketplace. When you apply for insurance using the Health Insurance Marketplace, you will be able to find out whether you qualify. There is more information on this process at www.healthcare.gov.  The plans in the Marketplace are offered by private insurance companies that compete for your business based on features and price. You may be able to save on out-of-pocket costs, too, meaning lower deductibles and lower payments (co-pays) each time you get care. All Marketplace insurance plans cover ER services, doctor and hospital charges, pregnancy, treatment for pre-existing conditions, mental health and substance abuse services, lab work, and other essential health benefits. Some include dental coverage.

What is a deductible? A deductible is the amount of money you will be required to pay before an insurance plan will begin paying for specific treatments. For example, if your plan provides for a $500 deductible, you will pay the first $500 of your medical bill before your insurance company will cover the rest.  Keep in mind that your deductible drops back to zero once per year, and you will need to find out the specific date that happens.

What is Open Enrollment? This is the yearly period when people can enroll in a health insurance plan. You may be able to enroll in a Marketplace health insurance plan outside of the Open Enrollment period if you qualify for Special Enrollment for life events such as getting married, having a baby, or losing other health coverage (such as if you lose a job that was providing health care benefits to you). Open Enrollment occurs in October of every year.

How do I know if I will save money using the Marketplace? There are a number of online tools at www.healthcare.gov to tell you whether your income is in the range to save by using the Marketplace.