Health Insurance Blog - Healthcare.gov
Income or household changes? Update your Marketplace application ASAP
Thu, 16 May 2019 00:00:00 -0400

If you're enrolled in a Marketplace plan and have changes to your income or household, update your application with these changes as soon as possible. Changes like higher or lower income, adding or losing household members, or offers of other health coverage may affect the coverage or savings you’re eligible for.

Image: {Couple updates their application with information changes on tablet}

What changes to report

  • Changes to your expected income for the year
  • Changes in health coverage, like someone in your household getting an offer of job-based insurance
  • Changes to your household or family, like a birth, adoption, or moving to a new address
  • Corrections to name, date of birth, or Social Security number
  • Changes in disability or tax-filing status

Check out the full list.

How to report changes

  • Update your application online, by phone, or in person — but not by mail. Here’s how.
  • Note: If you move to a different state, you’ll need to start a new Marketplace application. Learn more.

Get more information on reporting changes to the Marketplace.

Using your Marketplace insurance when you’re not sick
Thu, 02 May 2019 00:00:00 -0400

Did you know you can use Marketplace health insurance benefits even when you’re not sick? Here’s how you can take advantage of your health insurance benefits all the time:

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Get free preventive services

  • Most health plans must cover a set of preventive services, including shots, check-ups, and screening tests, at no cost to you.
  • Taking advantage of these services can prevent illnesses, disease, and other health problems, and detect illness at an early stage when treatment is likely to work best.

Get recommended health screenings

  • Marketplace plans cover chronic disease management and rehabilitative and habilitative services and devices.
  • Schedule any preventive appointments you need in advance. This way, you’ll have them on the calendar, and they won’t slip your mind.
3 questions to ask your doctor
Thu, 18 Apr 2019 00:00:00 -0400

It’s important to understand what services are covered by your insurance plan and what your costs may be before your doctor’s appointment. Here are some questions to ask:

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Does my health plan cover my current doctor?

  • Call your doctor’s office directly and ask if they accept your coverage. You can also check your health plan’s website and their provider directory.
  • You may also want to ask your plan if you need prior authorization before your visit. Without it, you may be charged for things your health plan would have paid for.

Does my health plan cover the services I need?

  • All private health insurance plans offered in the Marketplace offer the same set of essential health benefits, including prescription drugs, emergency services, and pregnancy, maternity, and newborn care.
  • Some plans may also offer additional coverage. If you have questions about whether a service is covered, contact your plan.

What will my costs be?

  • Most health plans give you the best deal on services when you see a doctor who has a contract with your health plan (also called an "in-network" provider). You may be able to see doctors who don’t contract with your plan (called "out-of-network" providers), but you may pay more out of pocket.
  • You can avoid any surprises before your appointment by taking the time now to learn which services in your plan aren’t subject to your health insurance deductible. Some plans charge only a copayment for primary care visits before you meet your deductible; others offer discounts on drugs, including generic drugs.
Only a few days left to file 2018 taxes
Thu, 04 Apr 2019 00:00:00 -0400

Tax day is right around the corner! Don’t miss the April 15, 2019 deadline to file 2018 taxes and report your health coverage. No matter how you got health coverage — whether through the Health Insurance Marketplace, your job, or another source — you must report your 2018 coverage status to the IRS when you file taxes.

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Get step-by-step directions & tax forms for your situation

You must file a federal tax return for 2018 — even if you usually don't file or your income is below the level requiring you to.

For instructions and forms for your situation, choose your 2018 health coverage status. Your next steps will depend on how you got health coverage last year.

Had a Marketplace plan in 2018?

If you or anyone in your household had Marketplace health insurance in 2018, you’ll use Form 1095-A to “reconcile” your premium tax credit on your 2018 taxes.

Can't find your 1095-A? Get help finding it.

2 steps to 'reconcile' your premium tax credit on 2018 taxes
Thu, 21 Mar 2019 00:00:00 -0400

If you had a Marketplace plan and used advance payments of the premium tax credit (APTC) to lower your monthly payment, you’ll have to "reconcile" when you file your 2018 taxes.

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Step 1: Check Form 1095-A for accuracy

Make sure your coverage and household information on your Form 1095-A is correct. If anything is wrong, contact the Marketplace Call Center.

Also, check your SLCSP by looking at Part III, Column B of your 1095-A, titled “Monthly second lowest-cost Silver Plan (SLCSP) premium.”

The SLCSP premium is incorrect if:

  • Part III, Column B has a “0” or is blank for any month someone in your household had the Marketplace plan.
  • You had changes in your household that you didn’t report on your Marketplace application — like having a baby, moving, getting married or divorced, or losing a dependent.

If either situation applies to you, use our tax tool to get your correct SLCSP premium.

Step 2: “Reconcile” your 2018 taxes

Now that you've made sure your SLCSP premium is correct and your coverage and household information is accurate, you’re ready to file.

How to check your Form 1095-A
Thu, 07 Mar 2019 00:00:00 -0500

If anyone in your household had Marketplace health insurance in 2018, you should have already received Form 1095-A, Health Insurance Marketplace Statement, in the mail.

Image: {Woman reviews Form 1095-A to file taxes at computer}

Before you file: 3 things to know about Form 1095-A

  • If you can’t find your 1095-A, check online. If your form didn’t come by mail or you can’t find it, check your online Marketplace account. When you follow these steps, be sure to choose your 2018 application, not your 2019 application.
  • Before you file, make sure your 1095-A is correct. Check basic health plan and household member information, and verify the premium for your second lowest cost Silver plan (SLCSP). If you find errors, contact the Marketplace Call Center. Don’t file your taxes until you have an accurate form.
  • You’ll use the information from your 1095-A to “reconcile” your premium tax credit. Once you have an accurate 1095-A and second lowest cost Silver plan premium, you’re ready to fill out Form 8962, Premium Tax Credit, and “reconcile.” You’ll compare the amount you used in 2018 to lower your monthly insurance payment with the actual premium tax credit you qualify for based on your final 2018 income. Get a step-by-step guide to reconciling.
Do you qualify for a Special Enrollment Period?
Thu, 21 Feb 2019 00:00:00 -0500

You can now enroll in or change a Health Insurance Marketplace plan only if you have a life event — meaning a change in your situation, like getting married, having a baby, or losing health coverage — that qualifies you for a Special Enrollment Period.

Image: {Dog pokes head out of moving box}

Life changes that may qualify you for a Special Enrollment Period

  • There are 4 basic types of qualifying life events: loss of health coverage, household changes, residence changes, and other qualifying events, like income changes that may affect your coverage options.
  • See the full list of all qualifying life events.

How to apply with a Special Enrollment Period

Learn more about getting 2019 Marketplace health coverage with a Special Enrollment Period.

Need to submit documents to confirm a life event?
Thu, 07 Feb 2019 00:00:00 -0500

If you’re eligible for a Special Enrollment Period to enroll in or change plans for 2019, you may be asked to provide documents to confirm the event that makes you eligible.

Image: {Woman submits documents electronically on computer to confirm life event}

Do I need to submit documents?

  • You’ll learn if you have to provide documents after you submit your application.
  • Details and instructions appear on your eligibility results screen and in a notice you can download or get in the mail.
  • If your eligibility results don’t say you need to, just pick a plan and enroll.

What document types can I provide?

How long do I have to send documents?

  • After you pick a plan, you have 30 days to send documents.
  • While your coverage start date is based on when you pick a plan, you can’t use your coverage until your eligibility is confirmed and you make your first premium payment.
3 things to know about 2018 taxes & Marketplace insurance
Thu, 31 Jan 2019 00:00:00 -0500

2018 tax filing season starts January 29, 2019. You must report information about your 2018 health coverage when you file. If you had Marketplace health insurance in 2018, check out these 3 tips:

Image: {Woman sits at computer with calculator, prepares to file taxes}

Keep an eye out for Form 1095-A

Make sure your Form 1095-A is correct

  • If anything about your coverage or household is wrong, contact the Marketplace Call Center.
  • Also, make sure the information about the “second lowest cost Silver Plan” (SLCSP) is correct.
  • Don’t file your taxes until you have an accurate 1095-A.

Get help, step-by-step instructions & tax forms

{% box %} IMPORTANT: Didn’t have health insurance in 2018?

If you could have afforded health insurance in 2018 but chose not to buy it, you may have to pay a fee when you file taxes this year. But starting with the 2019 plan year (for which you’ll file taxes in 2020), the fee no longer applies. {% endbox %}

3 ways to use your new Marketplace coverage
Thu, 17 Jan 2019 00:00:00 -0500

Now that you’re enrolled in a health plan for 2019, you can use your new coverage for regular and emergency care, prescription drugs, and preventive care.

Image: {Doctor wraps patient’s injured arm with bandage}

Getting regular & emergency care

  • You usually pay the lowest costs for services when you see a doctor who has a contract with your health plan. Visit your health plan’s website and check their provider directory to see which doctors are covered.
  • In an emergency, you should get care from the closest hospital. Your insurance company can't charge you more for getting emergency room services at an out-of-network hospital.

Getting prescription medications

  • Your health plan will help pay the cost of certain prescriptions. Visit your insurer’s website or review your plan’s Summary of Benefits and Coverage to see which prescriptions are covered by your new Marketplace plan.
  • Different health plans allow you to get your medications from different pharmacies. Call your insurance company or visit their website to find out if your regular pharmacy is in-network.

Getting free preventive care

Get more information on using your new coverage.

Ring in the New Year with free preventive services
Thu, 03 Jan 2019 00:00:00 -0500

Starting in 2019, take advantage of the free preventive services — like flu shots and screening tests — available with your Marketplace plan.

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What are preventive services?

  • Preventive services are routine health care procedures that include screenings, check-ups, and counseling to prevent illnesses, disease, and other health problems. These services can help detect illness early when treatment is likely to work best.
  • Preventive services are free when delivered by a doctor or other provider in your plan’s network.
  • Visit your health plan’s website and view their provider directory for a list of the doctors, hospitals, and other health care providers that your plan contracts with.

What services are covered?

Get more information on preventive and wellness services and chronic disease management.

See if you may still qualify for 2019 insurance
Thu, 03 Jan 2019 00:00:00 -0500

For most people, the deadline to enroll in 2019 health insurance has passed. But there are two ways you may still be able to get 2019 coverage:

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Through Medicaid or the Children’s Health Insurance Program (CHIP)

  • Medicaid and CHIP provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities.
  • If eligible, your coverage can start right away, any time of year. Medicaid and CHIP don’t have Open Enrollment Periods.
  • Learn more about Medicaid and CHIP, including how to apply.

Through a Special Enrollment Period

  • Outside Open Enrollment, you may qualify for a Special Enrollment Period if you have certain life events, like losing health coverage, moving, getting married, having a baby, or adopting a child.
  • If you qualify, you usually have up to 60 days following the event to enroll in or change a plan.
  • Not sure your life event makes you eligible? Just answer a few fast questions to find out.
Pay your premium: Make sure your coverage starts January 1
Thu, 20 Dec 2018 00:00:00 -0500

Now that you’ve enrolled in 2019 Marketplace insurance, you must pay your monthly premium for your coverage to start. You pay your premiums directly to the insurance company.

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How to pay your premium

Each insurance company handles premium payments differently. Follow your plan’s instructions about how and when to pay your premium. Make sure you continue your monthly payments. If you don’t, the insurance company could end your coverage.

You may be able to pay your monthly premium online at HealthCare.gov. Follow these steps:

  1. Log in to your Marketplace account.
  2. Click your name in the top right, and select "My Applications & Coverage." Choose your application under "Your Existing Applications."
  3. Click the blue button "Pay Your First Health Insurance Monthly Premium."
  4. If online payment is available, choose the green button "Pay for Health Plan Now" to go to your insurance company’s website to pay.

If your health insurance company doesn't accept online payment, they should have contacted you with next steps. Reach out to them if you haven’t received details on how to pay or aren’t sure if you paid.

Learn more about completing your enrollment by paying your premium.

2019 Open Enrollment is over, but you may still have options
Sun, 16 Dec 2018 00:00:00 -0500

If you missed the Open Enrollment deadline and didn’t enroll in 2019 Marketplace health insurance, you may still be able to get coverage for 2019 two ways:

Image: {Woman packing up boxes to move}

Enroll in or change 2019 plans with a Special Enrollment Period

  • If you experience certain life changes, like losing health coverage, getting married, or having a baby, you may be eligible for a Special Enrollment Period. This means you may be able to sign up for health insurance at other times during the year.
  • See the full list of life events that may qualify you for a Special Enrollment Period.
  • Not sure whether your life event qualifies? Answer a few questions to find out.

Apply for Medicaid or the Children’s Health Insurance Program (CHIP) any time of year

  • Medicaid and CHIP provide free or low-cost health coverage to millions of Americans, including some people with limited income, families and children, pregnant women, the elderly, and people with disabilities.
  • If you qualify, your coverage can start right away, any time of year.
  • Learn how to apply for Medicaid and CHIP.
Time’s running out for 2019 Marketplace insurance
Thu, 06 Dec 2018 00:00:00 -0500

Open Enrollment for 2019 Marketplace insurance ends next Saturday, December 15. This means you have just over one week to enroll in, re-enroll in, or change a 2019 Marketplace plan.

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Beat the December 15 deadline

  • First time applying at HealthCare.gov? Create an account.
  • Have 2018 Marketplace insurance? Log in to update your application and compare plans for 2019. If you don’t, you may be automatically re-enrolled for January 1, but you'll miss out on other options. New plans may be available, and your financial assistance may not be correct.

Questions? Help is available

Important: Update & compare plans by December 15
Thu, 29 Nov 2018 00:00:00 -0500

You can renew, change, or update your Marketplace plan for 2019 until December 15, 2018. That’s about 2 weeks away! If you don't update your application and enroll in a plan by the deadline, you may be automatically enrolled in a 2019 plan. While automatic enrollment is a good fallback, you may want to choose another option.

Image: {Man uses computer to update his application and compare plans online}

Log in, update & compare

  • Log in to your HealthCare.gov account to update your application with your expected 2019 income and household information.
  • Compare your current plan with other available 2019 plans. You may find a new 2019 plan with coverage and features that better meet your needs — especially if you’re expecting income or household changes.
  • Even if you want to keep your same plan, we strongly recommend that you update your information and check out all the plans available to you. If you don’t, you could miss out on savings and a plan better suited for your lifestyle.
  • Learn more about changing and renewing coverage for 2019.
3 reasons to enroll in 2019 Marketplace coverage
Wed, 21 Nov 2018 00:00:00 -0500

Staying healthy is important. This Thanksgiving, give yourself the peace of mind that comes with having health insurance. You have until December 15, 2018 to enroll in or change health insurance for 2019.

Image: {Doctor fixes man's broken leg}

Why bother with health insurance?

  • Health insurance provides financial protection in case you have a serious accident or illness. For example, a broken leg can cost up to $7,500. Health coverage can help protect you from high, unexpected costs.
  • With Marketplace coverage, you’ll get access to preventive services — like shots and screening tests — at no cost to you. Getting recommended preventive services is a key step to good health and well-being.
  • When you apply for insurance using the Health Insurance Marketplace, you’ll find out if you qualify for savings that can make insurance less expensive. Before you apply, select your household size, state, and income range to see if you may qualify for financial help.

Ready to apply? See the different ways to apply for 2019 health insurance.

2019 Open Enrollment ends in one month!
Thu, 15 Nov 2018 00:00:00 -0500

Attention: Open Enrollment ends December 15, 2018. You have just one month to enroll in or change Marketplace health insurance for 2019.

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Take action & apply

Questions? Help is available

Get a quick idea of 2019 savings and costs
Wed, 07 Nov 2018 00:00:00 -0500

You have until December 15, 2018 to enroll in or change 2019 Marketplace health insurance. Before you apply, get a quick idea of what your costs may be.

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Is your income in the range to save?

Ready to apply?

Open Enrollment for 2019 Marketplace coverage is here!
Thu, 01 Nov 2018 00:00:00 -0400

Starting today, you can apply for new 2019 health insurance — or renew, change, or update your 2018 health plan for 2019.

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Important dates

Before you apply: Preview plans & get ready

Ready to apply now? See the different ways to apply for 2019 health insurance.


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