FAQs

  1. What is the health insurance marketplace (also known as exchange)?
  2. Who can purchase a plan through the Marketplace?
  3. When can I shop for a health insurance plan?
  4. How do I found out if I am eligible for a subsidy?
  5. How do I access the Marketplace to compare plans?
  6. What happens if I don’t have health insurance?
  7. I would like to get health insurance but I can’t afford it? What can I do?
  8. In the past, I have been denied coverage due to a pre-existing condition. Will I be able to get health insurance?
  9. What are the essential health benefits that plans must provide?
  10. I am a small business owner. Do I have to provide health insurance for my employees?
  11. Where can I go for more information or to get help with the application process?

 

1. What is the health insurance marketplace (also known as exchange)?

The health insurance marketplace is a website where individuals, families and small businesses can compare and purchase insurance plans. The Marketplace will provide access to subsidies, which will help those at lower and middle income levels pay for health insurance.

2. Who can purchase a plan through the Marketplace?

Individuals or families can purchase health insurance on the Marketplace. Small business owners (those with fewer than 50 employees) can also purchase health insurance for their employees through the Marketplace. To purchase a plan, you must be lawfully residing in the U.S. and not be incarcerated.

3. When can I shop for a health insurance plan?

You can shop for a plan October 1, 2013 through March 31, 2014. Coverage will begin as soon as January 1, 2014.

4. How do I found out if I am eligible for a subsidy?

You are not eligible for a subsidy if your employer offers affordable health coverage that meets the minimum benefit requirements. If you are employed, talk to your employer about whether or not you are eligible for a subsidy. If you are unemployed, go to www.HealthCare.gov for more information. 

5. How do I access the Marketplace to compare plans?

You can access the Marketplace to compare and shop for a plan at www.HealthCare.gov.

6. What happens if I don’t have health insurance?

Starting January 2014, most Americans will be required to have insurance or they will have to pay a penalty. Through the online Marketplace, you can find out if you are eligible for financial assistance to help cover the cost of coverage.

7. I would like to get health insurance but I can’t afford it? What can I do?

By using the online Marketplace, you may receive financial assistance to help cover the costs of coverage. Here you will be able to compare and select an insurance plan that best fits your needs.

8. In the past, I have been denied coverage due to a pre-existing condition. Will I be able to get health insurance?

Starting January 2014, insurance companies will no longer be able to deny coverage or charge more based on health status.

9. What are the essential health benefits that plans must provide?

All health plans will cover the following set of essential benefits:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment (which includes counseling and psychotherapy)
  • Prescription drugs
  • Laboratory services
  • Rehabilitative and rehabilitative services and devices
  • Preventive & wellness services, and chronic disease management
  • Pediatric services, including oral and vision care

10. I am a small business owner. Do I have to provide health insurance for my employees?

Small business owners (those with fewer than 50 employees) can get health coverage through the Small Business Health Options Program (SHOP) Marketplace, but no employer is required to offer health coverage.

11. Where can I go for more information or to get help with the application process?

For more information, visit HealthCare.gov.