14 facts about the Health Insurance Marketplace®

Published on September 24, 2014

The Health Insurance Marketplace® makes it easier to find quality, affordable coverage. Millions of Americans have already gotten coverage, many for the first time.

Here are 14 things you should know about the Marketplace:

No matter what state you live in, you can use the Marketplace. Some states operate their own Marketplace, and in other states the Marketplace is run by the federal government. You can sign up for 2015 Marketplace coverage as soon as November 15, 2014.
Health insurance plans offered through the Marketplace are run by private companies.
Every health plan in the Marketplace offers the same set of essential health benefits, including doctor visits, preventive care, hospitalization, prescriptions, and more.
You can compare your options in the Marketplace and see what your premium, deductibles, and out-of-pocket costs will be before you make a decision to enroll.
After you fill out a Marketplace application you’ll learn if you’re eligible for lower costs on your monthly premiums. Most people who apply for health coverage through the Marketplace will qualify for some kind of savings.
You can apply for Medicaid or the Children’s Health Insurance Program (CHIP) through the Marketplace any time of year. These programs provide free or low-cost coverage to millions of Americans with limited incomes, disabilities, and certain family situations.
If you qualify for a Special Enrollment Period, you may apply for health coverage through the Marketplace outside the Open Enrollment Period.
Insurance plans offered through the Marketplace can’t deny you coverage because of pre-existing conditions like cancer or diabetes, and they can’t charge women and men different premiums.
In the Marketplace, you generally can get dental coverage as part of a health plan or by itself through a separate, stand-alone dental plan.
You must report certain qualifying life changes to the Marketplace, such as if you get married or divorced, have a child or adopt a child, or have a change in your income. After you report life changes to the Marketplace, you’ll get a new eligibility notice that will explain if you qualify for a Special Enrollment Period and lower costs.
Members of federally recognized tribes and Alaska Natives can enroll in Marketplace coverage any time of year, and they can change plans as often as once a month.
If you have an income-generating business with no employees, you’re considered self-employed and can get coverage through the Marketplace.
Even if you have access to a student health plan, you can choose to buy a health plan through the Marketplace instead. You may qualify for lower costs based on your income.
If you don’t agree with a decision the Health Insurance Marketplace® makes, like whether you’re eligible to buy a plan or whether you’re eligible for lower costs based on your income, you may be able to appeal the decision.