A Quick Guide to the Health Insurance Marketplace

Here’s an overview of the Health Insurance Marketplace, sometimes known as the health insurance “exchange.”

The Marketplace helps people without health coverage find and enroll in a plan

If you don’t have coverage through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source, the Marketplace helps you find and enroll in a plan that fits your budget and meets your needs.

You can apply online, by phone, or with a paper application. When you apply we’ll tell you if you qualify for:

• A health insurance plan with savings based on your income. Most people who apply qualify for premium tax credits that lower the costs of coverage. Some also qualify for savings on deductibles, copayments, and other costs. All plans cover:
  • Essential health benefits
  • Pre-existing conditions
  • Preventive care
• Medicaid and the Children’s Health Insurance Program (CHIP). These programs provide free or low-cost coverage to millions of individuals and families with limited income, disabilities, and some other circumstances. Many states are expanding Medicaid to cover all households below certain income levels. See if your state is expanding coverage.

You can apply for Medicaid and CHIP any time of year. There’s no limited enrollment period for these programs. If you qualify, coverage can start immediately.

Qualifying coverage, fees and exemptions

• You’re considered covered if you have any job-based plan, any plan you bought yourself, Medicare, Medicaid, CHIP, and many other kinds of coverage. See a full list.
• Most people must have qualifying health coverage or pay a fee. If you don’t have coverage in 2015, you’ll pay a penalty of either 2% of your income, or $325 per adult ($162.50 per child) —whichever is higher.
• Some people qualify for a health coverage exemption. If you do, you don’t have to pay the fee.

Questions? Contact us. We’re available by phone 24 hours a day, 7 days a week at 1-800-318-2596 (TTY: 1-855-889-4325).