Health Insurance Marketplaces

The government has set up markets where people can buy health plans.

The government is not going to sell health insurance – but it has set up Health Insurance Marketplaces where health insurance companies can sell their plans. There are also special Marketplaces, called the SHOP, where small businesses can make plans available for their employees. Some Marketplaces are run by a state, some by the Federal government, and some by both working together.

If your employer offers health insurance and contributes to the cost of coverage, that is likely to be your best choice. But if you aren't eligible for an employer-sponsored plan, or have an employer plan that is not considered "affordable" for you under the government standards, you may benefit from the Individual Marketplace.

Individual Marketplaces

The Individual Marketplaces offer a choice of plans providing different amounts of coverage at different prices. Buyers can review plan benefits, compare their plan options and buy plans. There are different levels of plans to choose from (Bronze, Silver, Gold and Platinum). These plan levels differ based on how you and the plan share the costs of your care. The categories have nothing to do with the amount or quality of care you get.

The Marketplaces have a set time period each year when you can compare and select a plan. The next Open Enrollment period when you can select a plan is November 1, 2015 – January 31, 2016. After the open enrollment period ends, you will not be able to buy a plan through the Marketplace (unless you have a qualifying life event, for example, if you get married or have a baby) until the next annual open enrollment period.

You can shop and apply for a plan through the Marketplace in one of three ways: online, by mail, or in person with help from Navigators, insurance brokers or agents.

How can I get help to buy a plan on the Individual Marketplace?

The federal government determines your eligibility for financial assistance (subsidy). However, you can find a helpful chart from Health Care, that may give you a general idea whether you qualify for a subsidy.