In the United States, having health insurance is a necessity of life. It’s important for ensuring access to the regular preventative care that maintains good health as well as to avoid potentially catastrophic debt during a health crisis. It’s also, of course, the law. Since the implementation of the Affordable Care Act in 2012, all Americans have been required to have health insurance or pay a penalty for noncompliance. Finding a plan that fits your needs and budget can feel like a complicated task if you don’t receive health insurance benefits through your employer. But there are systems in place to help you along. Every year, during the Open Enrollment Period that begins November 1st, Americans without health insurance have the opportunity to purchase an affordable plan through the insurance marketplace organized either by their state or the federal government.
Insurance Marketplace
The Health Insurance Marketplace (sometimes called the Health Insurance Exchange) is a resource for information about different plans—as well as the actual place to purchase them.
Part of the application process is determining eligibility for subsidies of premiums or out-of-pocket costs; Americans with a lower income have access to steeply-discounted rates. But the idea is that everyone of every income will pay much less by purchasing from these specially organized programs that are designed to cut costs.
The first step to purchasing a plan is visiting healthcare.gov and entering your zip code to determine which marketplace corresponds to you. States like California, Colorado, and Massachusetts have their own programs and you will automatically be re-directed to the correct website for your state.
Americans in the 41 states without these programs are instead served by the federally-organized marketplace and can continue with the application process on healthcare.gov. The federal open enrollment period lasts for six weeks, but many states have a later deadline—in the case of some, all the way up to January 31st. There are also special enrollment periods throughout the year available for taxpayers that qualify based on criteria like income and household size. To know where you stand visit healthcare.gov or the corresponding website for your state.
When you purchase insurance in these marketplaces, it’s very important to report any updates in your circumstances, such as changes in how much you earn or how many people you support. All of these factors can affect which plans are available to you and how much they cost. Updating your information could also mean that you now qualify to participate in the marketplace at one of the special enrollment periods outside of the regular open enrollment.
You can actually get some sense of how these different factors will affect the cost of your premiums (which is to say how much premium tax credit you can claim when you fill out your annual returns) using a tool on IRS.gov/ACA called the Premium Tax Credit Change Estimator. It’s important for all Americans without health insurance to educate themselves on the different options available to them on these insurance marketplaces—begin the process by visiting healthcare.gov.
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