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I’m leaving my job and will be eligible for COBRA. Can I shop for coverage and subsidies on the Marketplace instead?
Yes, leaving your job and losing eligibility for job-based health coverage will trigger a special enrollment opportunity that lasts for 60 days. You can apply for Marketplace health plans and (depending on your income) for premium tax credits and cost sharing reductions during that period. If you enroll in COBRA…
FAQ Read MoreI live in State A but my small business is in State B. I want to buy group coverage for my employees through the SHOP Marketplace. In what state should I buy health benefits?
You should buy group coverage through the SHOP Marketplace in State B, where your business is located. If your business is located in a HealthCare.gov state, there is no SHOP Marketplace website. Instead, you should contact insurers directly or work directly with a broker to buy a small group policy. …
FAQ Read MoreI’m behind on my premium payments and trying to catch up, but meanwhile I got sick and needed health care. Does my health plan have to pay these claims?
If you are receiving advanced premium tax credits, the insurer is required to pay your claims during the first 30 days of the grace period. After that, during the second and third month of the grace period, the insurer is allowed to hold your claims and only pay them if…
FAQ Read MoreI am age 60 and have been receiving Social Security disability insurance (SSDI) payments for two years. I recently received my Medicare card, and I would like to get coverage to supplement my Medicare Part A and Part B coverage. I live in a state that does not require insurance companies to sell Medigap supplemental policies to people under age 65. Can I purchase a Marketplace plan to supplement Medicare?
No, companies that sell Marketplace plans are prohibited from selling these plans to you if they know you are covered by Medicare. If you do not live in a state that requires insurance companies to sell Medigap policies to people under age 65, some insurance companies still may voluntarily sell…
FAQ Read MoreI am covered by Medicare. Can I keep my Medicare coverage even though these Marketplace plans are available, or do I need to make a change?
Yes, you can keep your Medicare and you do not need to make any changes to your coverage because of the ACA. Browse more questions in the Marketplace Eligibility section.
FAQ Read MoreCan family members in families with mixed immigration status, where some family members are citizens or lawfully present and others are undocumented, enroll in Medicaid or CHIP or receive help buying coverage through the Marketplaces?
Citizen and lawfully present family members can get health insurance coverage through Medicaid, CHIP, and Marketplaces even if other family members are not lawfully present. Family members who are not lawfully present, including undocumented immigrants, may apply for health insurance for citizen and lawfully present family members. For example, an…
FAQ Read MoreI’m eligible for health benefits at work but want to see if I can get a better deal in the Marketplace. Can I do that?
You can always shop for coverage on the Marketplace, assuming you meet other eligibility requirements, but if you have access to job-based coverage, you might not qualify for premium tax credits. Browse more questions in the Employer-Sponsored Health Coverage section.
FAQ Read MoreCan I buy a plan in the Marketplace if I don’t have a green card?
If you are not a U.S. citizen, a U.S. national, or an alien lawfully present in the U.S., you are not eligible to buy a plan on the health insurance Marketplace. However, you can shop for health insurance outside of the Marketplace in the non-group market. Insurers outside of the…
FAQ Read MoreA Court Ruling Striking Down the ACA Would Eliminate the Medicaid Expansion and Cause Millions of Low-Income People to Become Uninsured
Millions of low-income Americans currently covered by Medicaid likely would become uninsured if the Supreme Court were to strike down the Affordable Care Act in California v. Texas, a legal challenge the high court is scheduled to hear in early November, KFF experts explain in a new Policy Watch post.…
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Understanding Health Insurance
These resources are for anyone shopping (or helping someone shop) for health coverage within the health insurance marketplaces created through the Affordable Care Act (also known as the ACA or Obamacare).
In healthcare.gov states, the open enrollment period for 2021 coverage begins on Sunday, November 1, 2020 and runs through Tuesday, December 15, 2020. State-run Marketplaces can set their own dates, and several will have a longer open enrollment period for 2021 coverage.
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