Health Insurance Marketplace Explained

The Affordable Care Act a.k.a. Obamacare has created a category of health insurance policies. These new policies will be sold on Health Insurance Marketplace. Health Insurance Marketplaces are also called Health Insurance Exchanges in some states.

Health insurance companies still continue selling their traditional health insurance plan, but some of them also sell a separate category of plans called qualified insurance plans through Health Insurance Marketplaces.

As per the provisions of Obamacare, Health Insurance Marketplace will start offering health coverage from January 1, 2014. What are marketplace health plans and how will they affect you? Before I go into the details let me share some key dates and resources.

  • Health Insurance Marketplace will start open enrollment from November 1st through December 15th. Prices (premium) for marketplace health plans will be available from the same date.
  • Some (but not all) plans will start offering coverage from January 1, 2021.
  • Open enrollment closes on December 15th. Those who miss this deadline can enroll in Health Insurance only if they have a qualifying life event like death or birth in the family, job loss, moving to a new state, change in income, and divorce.
  • The Health Insurance Marketplace’s official website is located at HealthCare.gov and I suggest you visit it. You should also subscribe to email updates from HealthCare.gov.
  • States are creating their own health insurance marketplaces. You should check out your state’s marketplace website. 

The graphics below explains how health insurance marketplace works.

So What is Health Insurance Marketplace?

It offers affordable (lower cost) private health insurance to individuals, families, and small businesses. Health insurance is offered by private companies.

Health Insurance Marketplace simplifies the process of buying health insurance. The applicant needs to fill only one application to see all options.

The marketplace is administered by federal or state government. The marketplace is divided into two parts.

1. Marketplace for Individuals and Families

The marketplace allows individuals and families with low income to buy high quality and affordable health insurance. Health insurance marketplace for individuals and families will have two unique features.

  • Health insurance companies will not reject applicants for past & preexisting conditions, age, and high risk.
  • Individuals and families qualify for lower premium and out of pocket costs based on annual income.

2. Marketplace for Small Businesses

 Who Runs The Marketplace?

The marketplace is run by the State government or the federal government. If your state government is running the marketplace then you should visit the state government website for details. Else you should visit healthcare.gov.

If you live in the following states you should use HealthCare.gov.

Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin.

 

Who Can Enroll?

Anyone can enroll in Marketplace Health Insurance. 

What are the Benefits of Enrolling?

After enrolling you can use the marketplace tools to compare insurance plan. You can check if you are eligible for lower monthly premium. The marketplace website also tells if you qualify for a government aided program like Medicaid.

Who Can Find Coverage Through Marketplace?

Anyone can buy from the marketplace. The marketplace offers standard policies with transparent pros and cons. Those who don’t have insurance because they can’t afford it or the carrier will not cover will benefit the most.

For more information on Marketplace Plans or if you qualify for a Special Enrollment, please contact Group Plans Inc at (623)-889-7600. We can assist you from start to finish in finding the best plan that suits your needs, without all the stress or potentially confusing hassle.