Health Care Market Place FAQ: Everything You Need to Know

Choosing the right health insurance plan can be a daunting process – there are qualifications and requirements, plus lingo that doesn’t always make sense.

Choosing the right health insurance plan can be a daunting process – there are qualifications and requirements, plus lingo that doesn’t always make sense.

You need to be able to review your options and compare your choices without all the noise. And you need answers to some important questions.

Fortunately, you’re not the only one with questions. This health insurance market place FAQ will answer your most pressing questions without all the fuss.

Health Insurance Market Place FAQ: What You Need to Know

Health Insurance Market Place FAQ
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You want to make an informed decision about your health insurance. These are some of the most common questions people ask about the health insurance marketplace.

1. How does the health insurance marketplace work?

The health insurance marketplace is a platform that allows Americans to apply for insurance. You can fill out an application online, which will let you know if you qualify for any savings on your health insurance premiums. To apply, you’ll need some information:

  • Home and/or mailing address
  • Information about everyone who needs coverage
  • Social Security Numbers
  • Information about any help applying for coverage
  • Immigration information
  • Information about your taxes
  • Employer and income information
  • Information about your current health coverage

Once you’ve completed your application, you can review all the health insurance plans available in your area. You’ll be able to calculate your healthcare costs, as well as compare the plans to see which is best for you.

2. How do you qualify for insurance through the marketplace?

During open enrollment, anyone can apply for coverage through the health insurance marketplace as long as they have the required information. There are, however, qualifications for other aspects of the marketplace.

If you want a catastrophic plan, for example, you need to be under 30 or have a hardship exemption.

You’ll also need to qualify if you want any kind of financial assistance with your health insurance premiums.

You’ll need to wait for a special enrollment period to apply for coverage If you miss the open enrollment deadline. Special enrollment periods include things like a new baby, loss of health insurance, or moving to a new state.

3. What are the income limits for insurance through the marketplace?

While there are no income limits to purchase insurance through the marketplace, there are income limits for premium tax credits and Medicaid/CHIP coverage.

Your household size determines the income limits for premium tax credits:

  • Individuals: If you make between $12,760 and $51,040 each year, you may qualify for premium tax credits. Individuals that make less than $31,900 per year may also qualify for cost-sharing plans.
  • Family of three: A family of three that makes between $21,720 and $86,880 per year may qualify for premium tax credits. Larger families will have higher income limits.

As with premium tax credits, your household size determines income limits for Medicaid/CHIP coverage. If you live in a state that expanded Medicaid coverage, your income limits are:

  • Individuals: An individual that earned less than $17,236 per year in 2019 may qualify for Medicaid coverage. Due to covid-19, we recommend contacting your insurance provider for this year’s enrollment.
  • Family of three: A family of three that earned less than $29,435 per year in 2019 may qualify for Medicaid coverage. Due to covid-19, we recommend contacting your insurance provider for this year’s enrollment.

CHIP coverage is available to families with children whose income was around $42,000 per year in 2019. Due to covid-19, we recommend contacting your insurance provider for this year’s enrollment.

4. How long does it take to get insurance through the marketplace?

Getting insurance through the marketplace doesn’t take a lot of time in most cases. You can fill out your application online, and a lot of people can review plans immediately. In a few cases, the marketplace may request documents from you. You can submit these documents through the portal and usually have an update within a couple of days.

If you’re applying for coverage for 2021 and you apply by the December 15, 2020, deadline, your coverage will begin on January 1, 2021. If you apply for coverage during a special enrollment period, you can usually get coverage that begins the next month.

5. How much does insurance through the marketplace cost?

The truth is that the cost of insurance plans through the marketplace varies. Without any premium tax credits or cost-sharing insurance options, bronze plans typically start out at under $400/month for an individual. A platinum plan for an individual cost upwards of $1,000/month.

If you have a spouse or dependents to add to your plan, your costs will be higher. You can, however, use the built-in healthcare calculator to get an idea of how much you’ll spend with different plans. It may cost less for you to choose a more expensive plan.

Health Insurance Market Place FAQ: Tips for Choosing a Plan

When you need to make the best decision for your family’s healthcare, the marketplace is the most affordable place to get coverage. The hard part isn’t qualifying or applying for coverage – it’s choosing the right plan.

Here are some questions to help you choose the right health insurance plan:

  • Do you know your family’s medical history? It’s good practice to keep a list of your family’s history so you know what signs and symptoms to watch for. You may need more coverage if your family has extensive health conditions.
  • How much insurance can you afford? You need to think about your monthly premiums plus any other routine medical expenses, like doctor visits, lab tests, or regular prescriptions. You’ll also want a plan in case you have a serious medical emergency.
  • What doctors and hospitals do you use? If you already have a doctor, you may want to make sure your new health insurance plan is accepted by your doctor or clinic. You also want to make sure any specialty services you receive are covered.

If you take the time to answer these questions, you’ll have a better picture of how much health insurance you need.

Health Insurance Market Place FAQ: Apply Today

Even if you know what you’re doing, applying for coverage through the health insurance marketplace can be a painful process. These questions were put together to help make that process a little easier. However, there are options for getting help with your health insurance. An insurance agent or broker can help you through the entire process.

Looking for help with the health insurance marketplace? Talk to the team at Fiorella Insurance Agency to get your application started today.

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