In light of ongoing health reform debates and a significantly shorter open-enrollment period, it’s no surprise that Americans—including older Americans and caregivers—have a lot of questions about health coverage. Here are five things you and your patients need to know about the Health Insurance Marketplace (sometimes known as the health insurance “exchange”).
- Americans with Medicare may have questions about the insurance marketplace. If you are on 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 here.
- If you don't have health insurance through Medicare, Medicaid, the Children's Health Insurance Program (CHIP), or another source (like your employer) that provides qualifying health 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 these standards.
- The period (sometimes called “open enrollment”) when you can enroll in a marketplace insurance plan runs through December 15. After December 15, you can enroll in health insurance only if you qualify for a Special Enrollment Period.
- Remember: You still need to review plan options even if you had a marketplace plan last year and plan to continue it.
- Coverage sold during open enrollment takes effect on January 1 of the next calendar year.
- What you pay for insurance depends on your income. Get a quick idea of your potential savings by answering a few questions here. Based on your income estimates, Healthcare.gov will tell you if you qualify for:
- A health insurance plan with savings based on your income
- A premium tax credit that lowers your monthly insurance bill
- Plans offered by private insurance companies with a range of prices and features
- Medicaid and the Children’s Health Insurance Program (CHIP)
- Consult the Healthcare.gov checklist to make sure you have what you need to apply for or renew a marketplace plan. When you’re ready (and have what you need), you can apply for coverage 4 ways.