Health Care Reform: Enrolling in Health Insurance Marketplace
Under the Affordable Care Act (ACA), online insurance exchanges called Marketplaces were created to help standardize and streamline the individual insurance market. By enrolling in a health plan through the Marketplace, you can receive guaranteed consumer protections while maintain the flexibility to choose a plan that’s right for your individual needs.
Open enrollment started last year, and with coverage going into effect on January 1. While Marketplace enrollment is now closed for this year, enrollment for 2015 will be starting up in the fall of 2014.
There are four steps to obtaining coverage through the Marketplaces.
Set up an account. You’ll provide some basic information to get started, like your name, address and email address.
Fill out on online application. You’ll provide information about you and your family, such as income, household size, current health coverage information and more. This will help the Marketplace find options that meet your needs.
Compare your options. You’ll be able to see all the options for you and your family, including private insurance plans and free or low-cost coverage through Medicaid and the Children’s Health Insurance Program (CHIP). The Marketplace will tell you if you qualify for lower costs on your monthly premiums and out-of-pocket costs on deductibles, copayments and coinsurance. You’ll see details on costs and benefits before you choose a plan.
After you choose a plan, you can enroll online and decide how you pay your premiums to your insurance company. If you or a member of your family qualifies for Medicaid or CHIP, a representative will contact you to enroll. Help is available if you have questions along the way.
Marketplace Application Checklist
When you apply for coverage in a Marketplace, you’ll need to provide some information about you and your household. It is a good idea to get this information together now so that you are ready when the time comes to enroll. Items required to enroll include:
Social Security Numbers (or document numbers for legal immigrants)
Employer and income information for every member of your household who needs coverage (for example, from wage and tax statements such as pay stubs or Forms W-2)
Policy numbers for any current health insurance plans covering members of your household
A completed worksheet—called an Employer Coverage Tool—for every job-based plan you or someone in your household is eligible for. You’ll need to fill out this form even for coverage you’re eligible for but don’t enroll in.
Note on Different Marketplaces
Some states run their own Marketplace. In other states, the Marketplace is run by the federal government. Either way, you get the same access to all of your Marketplace coverage options. Be sure to find out who runs your state’s Marketplaces for specific instructions on enrollment. In Iowa, the Marketplace is run by the federal government. Click here to get started on the Iowa application process.
The launch of an entirely new system for obtaining health insurance is an extremely complex undertaking. The Marketplace will offer several kinds of assistance to help you apply for coverage and choose a plan that meets your needs, including:
In all states, there will be people trained and certified to help you understand your health coverage options and enroll in a plan. Though all will provide similar kinds of help, they will be known by different names, depending on who provides the service and where they are located:
Certified application counselors
Insurance agents and brokers can also help you with your application and choices.
When open enrollment starts in November 2014, the Marketplace Help Center will assist you in finding the kind of help that works for you.
Get help filling out an application online
The Marketplace website walks you step-by-step through the online health coverage application. It keeps track of where you are and guides you through to the end. If you have to stop your application and come back later, the Marketplace lets you re-start where you left off.
Useful information on each page explains the questions being asked, how much time each step might take and whether you’ll need any forms or other documents. If you want live help while you apply, you can call the toll-free support center or chat with someone online.