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FAQs: Health Insurance Marketplace and the ACA

This list of more than 300 Frequently Asked Questions (FAQs) covers the Affordable Care Act’s health insurance Marketplace (aka exchange), individual mandate, open enrollment, premiums and more. It provides answers to questions about specific groups, such as young adults, smokers, the uninsured, and non-traditional households.

What is the health insurance Marketplace?

Health Insurance Marketplaces (also known as Exchanges) are organizations set up to create more organized and competitive markets for buying health insurance. They offer a choice of different health plans, certify plans that participate, and provide information and in-person assistance to help consumers understand their options and apply for coverage.…

Who can buy coverage in the Marketplace?

Most people can shop for coverage in the Marketplace. To be eligible you must live in the state where your Marketplace is, you must be a citizen of the U.S. or be lawfully present in the U.S., and you must not currently be incarcerated. Not everybody who is eligible to…

Can 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…

I live in different states during the year. My summer home is in a northern state; my winter home is in a southern state. Where do I sign up for health coverage? And if I sign up for a plan in one state, how do I find in-network health providers in the other state?

You should buy coverage in the state where you officially reside. Most states consider you a resident if you intend to make that state your permanent home. So-called “snowbirds” may own a second home and live part of the year in another state, but their official state of residence is…

I 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. …

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.