Welcome to the Health Insurance Marketplace

One of the biggest innovations brought on by the Affordable Care Act (aka Obamacare) are the health insurance marketplaces.  Some states have their very own marketplace. For example, California’s will be run by Covered California; Arkansas Health Connector will be the marketplace for that state; while Connect for Health Colorado will be in charge of health insurance for the Centennial State. In other states, marketplaces are federally run. These marketplaces are also known as insurance exchanges, so if you hear both terms be sure not to think they’re different things, much like many people still believe the Affordable Care Act to be different from Obamacare.

The health insurance marketplaces are required by federal law to be certified and functional by the first of January, 2014. However, consumers have been able to apply for coverage, even online, since October 1st. It’s very important to buy insurance before March 31st, 2014, lest you are fined for failing to do so. That is unless you’re already covered. A person is deemed covered if they have Medicare, Medicaid, State Children’s Health Insurance Program (CHIP), COBRA, retiree coverage, TRICARE, or Veteran Affairs health coverage, among others. If you have employer-sponsored insurance you’re also covered, but you have the chance to switch to a marketplace program if you desire to; the same goes for individual insurance.

In order to enroll in a marketplace online, you need to provide basic personal information to create an account with a user name and a password. Then you fill in the actual application with info about you and your family, income, household size, etc. The plans that you qualify for will be displayed in such a way as to allow a side-by-side comparison. The last step is to pick the best plan for you and enroll; if you do so by December 15, 2013 you can be covered as soon January 1st of the following year. Regardless of which plans are available for you to pick, you cannot be turned down on the basis of a pre-existing condition.

You will receive a series of essential health benefits with any plan you choose. These benefits include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services and devices, lab services, preventive and wellness services, and pediatric services. These are every plan’s minimum requirements, but further benefits may be available as well. Please bear in mind that the cost of marketplace insurance coverage varies from state to state, but you may be eligible for lower premiums and out-of-pocket expenses for copayments, coinsurance and deductibles.