What You Need to Know about the Health Insurance Marketplace

Affordable Care Act

You hear the term all the time these days, but what exactly is the Health Insurance Marketplace? It’s all over the news, it is making headlines and it is something that you just can’t help but see on an almost daily basis. But you still don’t have a clue what it is. It happens; it’s something that most people are unfamiliar with despite the sheer nature of the beast. Perhaps you pretend you know exactly what it is because so many people discuss it and you don’t want to seem like the odd person out wondering exactly what it is that has everyone so up in arms. Healthcare is, admittedly, a very sensitive subject these days. It’s not something people enjoy talking about. It’s something that people are upset over. That’s not to say everyone in the country hates health insurance these days; there are plenty of families happy about the new health insurance policies in place as they are now able, for the first time, to pay for insurance for their families. The rest of us, however, might not be as happy since our premiums became significantly more expensive. Before you jump to conclusions or let the influences of others sway your own opinion of what’s going on in the marketplace, let us help you learn precisely what this means.

What is the Health Insurance Marketplace?

It’s where you shop for health insurance; it’s really that simple. You can call and speak to someone about insurance or you can go online and look it up for yourself. It’s a place you go to find health coverage that’s right for your family. It’s designed to help people in all walks of life find healthcare coverage regardless of your income or your location. This is where you can compare policies to see what might work best for you, find the prices you want and look for things that might help you apply for health insurance.

Who Can Use the Marketplace?

Is the health insurance marketplace for everyone? The simple answer is no. there are some people who cannot use the marketplace to find healthcare. For example, anyone in prison is not eligible to use the marketplace for health coverage. Of course, that makes sense but who is shopping for health care from behind bars, anyway? You also have to be a legal US resident or citizen with the proper documentation and paperwork. Finally, anyone with Medicare coverage is prohibited from using the marketplace to find healthcare or dental coverage.

Are There Specific Deadlines I Should Know About?

There are very specific deadlines you should know about if you plan on using the health insurance marketplace to find health care coverage. It’s not the same as open enrollment that ended on December 15. The marketplace is open through February 15 and anyone who uses the marketplace is eligible to receive healthcare coverage between now and then. Coverage will not start until the first day of the month following your enrollment in health insurance plans in the marketplace. For example, if you enroll on January 8 for health insurance, your coverage will not take effect until February 1. You will not be covered for a few weeks and your insurance will not backdate to cover that uninsured time once it does take effect.

If you do not enroll in the marketplace for insurance on or before February 15, you will not be eligible to receive healthcare coverage for the rest of 2015. This means you will spend the entire year without health insurance and you will pay a penalty when you file your income taxes in 2016. This is a big deal for those who might consider it not quite a big deal.

There are some exceptions. If you fall into a special life scenario such as marriage or the birth of a new child, you will find that you can enroll for insurance throughout the rest of the year. For example, if you have a baby or adopt a baby, you can enroll in health care coverage through the marketplace or other health care companies for approximately 60 days following the date your life changes. If you fail to do this, you will not be granted health insurance for your new family.

How are Plans and Prices Determined?

There is no real one answer for this question. Prices and plans are determined based on several different factors. For example, your income, your age, your health, the size of your family and the number of people in your family looking for coverage are all considered when you are looking for plans, policies and coverage. And we cannot tell you what they will be because it all depends on a mixture of all plans. Those who have a certain income limit are going to be eligible for some financial tax credits that will lower the cost of their health insurance premiums each month. Those who have larger families and higher incomes might also qualify for tax credits that will lower the overall cost of their health insurance. It all depends on your personal situation. A single person with an income of $50,000 per year will not receive benefits, but a person with a family and the same income level might receive tax credits to lower the cost of insurance.

Is it Worth It?

This is the question people ask most. Is finding a health insurance plan on the marketplace worth it? The answer is simple; yes. You have to have coverage for many different reasons, and it’s only natural that you would want to go ahead and find that coverage now before it is too late. Go ahead and check out the marketplace to see what is available to you so that you can apply for a plan. It’s the best way to prepare yourself for potential health disasters that could occur if something were to happen. And even if you are healthy now, you never know what the future could hold. Accidents happen all the time when you’re not expecting them.

Photo by David McNew/Getty Images

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