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Health Insurance Blog - Healthcare.gov
10 Marketplace health benefits
All Marketplace health insurance plans must cover 10 categories of essential health benefits. Essential health benefits are minimum requirements for all Marketplace plans. Specific services covered in each category may be different based on your state's requirements.
10 covered benefits:Plans must also include birth control and breastfeeding coverage. Some plans may offer dental and vision coverage.
POSTED JULY 11, 2024 |
Moving can impact your coverage options and savings
A new address may mean new health coverage and savings options. Report your address change to get the right plan and savings for your household.
Move within the same state:Move to a new state:- You'll need to start a new Marketplace application and pick a new plan.
- Some states have their own Marketplace. Check your state.
Get details on how to report a move.
POSTED JUNE 27, 2024 |
Marketplace coverage after birth or adoption
When a new baby arrives, you have a Special Enrollment Period for health coverage. You have 60 days to enroll in or change Marketplace coverage for your baby — and all household members on your Marketplace application. You may have new coverage options with better savings.
Update your application onlineLearn more about Special Enrollment Periods and how to apply.
POSTED JUNE 13, 2024 |
Lose Medicaid or CHIP? Stay covered 4 ways
You have health insurance options if you lose Medicaid or Children’s Health Insurance Program (CHIP) coverage.
4 ways to stay covered1. Get a Marketplace health plan. Most people qualify for savings to lower what they pay for their monthly premium and when they get care. - You can apply and enroll in a Marketplace plan as early as 60 days before your Medicaid or CHIP coverage ends to avoid a gap in coverage.
- From March 31, 2023 – November 30, 2024, you can apply for a Marketplace plan any time after your Medicaid or CHIP coverage ends. You have 60 days after submitting your application to enroll in a plan. Your coverage starts the month after you complete your enrollment.
2. Re-apply for Medicaid or CHIP through your state. You may still qualify. 3. Decide between a job-based plan or Marketplace coverage, if your employer offers health insurance. 4. Sign up for Medicare, if you qualify (like if you’re 65 or older). Learn more about staying covered if you lose Medicaid or CHIP.
POSTED MAY 30, 2024 |
Health coverage for young adults
Health insurance can protect you at any age.
4 health insurance options for young adults:- Your college or university: If you're in school, you can enroll in a student health plan.
- A parent’s plan: If you’re under 26, you may be able to join a parent’s health insurance plan.
- The Marketplace: You can enroll during Open Enrollment November 1 – January 15 or at other times of the year if you have certain life events (like a move) or if your income is within a certain range. Get a quick overview of the Marketplace.
- Medicaid: You may qualify for free or low-cost coverage through Medicaid. You can apply any time and if you’re eligible, you can enroll immediately.
Learn more about getting covered if you’re under 30.
POSTED MAY 16, 2024 |
Changes big or small, let the Marketplace know
Whether you moved to a new state or had or adopted a baby, let the Marketplace know. You may qualify for new savings or coverage options.
Get the full list of changes to report. Ready to report? You can update your application to report a life change online, with an assister in your community, or by calling 1-800-318-2596 (TTY: 1-855-889-4325). Log in to update
POSTED MAY 02, 2024 |
Preventive services you don’t want to skip
Put your health first – get free preventive services. Screenings, check-ups, counseling, and keeping a healthy lifestyle can help you avoid more serious illnesses. You and your doctor can decide which services are right for you. Remember that services are free only when delivered by a doctor or other provider in your plan’s network.
What are some common preventive services?Common preventive services include: - Blood pressure screenings
- Cholesterol screenings (for certain people at higher risk)
- Depression screenings
- Vaccines
Get more information on preventive services available to you and your family. How can I find a provider in my network?There are a few ways to find in-network providers: - Check your plan's provider directory by contacting the plan or visiting the plan's website.
- Call your insurer to ask about specific providers.
- Call your doctor's office.
Learn more about getting the most out of your coverage.
POSTED APRIL 18, 2024 |
The time to file taxes is almost over. Here’s what to know
The last day to file your 2023 federal income taxes is April 15, 2024. If anyone in your household had Marketplace coverage in 2023, you’ll use Form 1095-A, Health Insurance Marketplace® Statement to file. (If you didn’t get Form 1095-A in your Marketplace account or by mail, or if the information on it is wrong, contact the Marketplace Call Center.)
How to “reconcile” your tax creditIf you (or anyone in your household) qualified for or used the premium tax credit to lower your Marketplace plan premium at any point in 2023: - You’ll use your Form 1095-A to fill out IRS Form 8962, Premium Tax Credit (PDF, 110 KB) to reconcile your 2023 premium tax credit when you file your taxes.
- Any difference between the amount of premium tax credit you used last year and the premium tax credit you actually qualify for based on your final income will affect your refund or taxes you owe.
- Report any differences on your taxes and include Form 8962 when you file.
- Get step-by-step directions on how to reconcile.
POSTED APRIL 04, 2024 |
Find out if you qualify for a Special Enrollment Period
You may be able to enroll in or change your Marketplace plan outside of Open Enrollment. Life events or changes may open a Special Enrollment Period for you.
What kinds of life events?- Changes in household, like getting married or having a baby
- Changes in residence, like moving or going away to school
- Loss of health insurance, like job-based or individual coverage
Get a full list of qualifying life events. I experienced a life event. What do I do next?Report your change to the Marketplace by updating your application. You can do this online, by phone, or in person. Not sure if you qualify for a Special Enrollment Period? Answer a few questions and find out your options. We'll also tell you if you may qualify for free or low-cost health coverage through Medicaid or the Children’s Health Insurance Program (CHIP).
POSTED MARCH 21, 2024 |
File your taxes using Form 1095-A, Health Insurance Marketplace Statement®
The tax filing deadline is April 15, 2024. If anyone in your household had a Marketplace plan in 2023, use Form 1095-A, Health Insurance Marketplace®, to file your federal taxes. You’ll get this form from the Marketplace, not the IRS.
It’s important to review your Form 1095-A and reconcile your premium tax credit because it could impact your refund or the amount of taxes you owe. Check your online account for Form 1095-AIf you didn’t get your Form 1095-A in the mail, or you can’t find it, check your Markteplace account. - Under "Your Existing Applications," select your 2023 application.
- Select “Tax Forms” from the menu on the left.
- Download all 1095-A forms shown on the screen.
Check your Form 1095-A to make sure your information is correct. If you can’t find your form or think there’s a mistake, contact the Marketplace Call Center. “Reconcile” using Form 1095-AIf you (or anyone in your household) qualified for or used the premium tax credit to lower your Marketplace plan premium:
POSTED MARCH 07, 2024 |
Insurance Archives - KFF Health News
California Health Care Pioneer Goes National, Girds for Partisan Skirmishes Anthony Wright, a champion for Californians’ health care rights, will take the helm of Families USA in Washington, D.C., where he plans to campaign for more affordable and accessible care nationally. He leaves Health Access California, where he helped outlaw surprise medical billing, require companies to report drug price increases, and cap hospital bills for uninsured patients.
POSTED JULY 15, 2024 9:00 AM |
‘A Bottomless Pit’: How Out-of-Pocket TMJ Costs Drive Patients Into Debt Millions of Americans suffer from temporomandibular joint, or TMJ, disorders. The high cost and poor insurance coverage of TMJ care can bury patients in debt even as the treatments do more harm than good.
POSTED JULY 11, 2024 11:31 AM |
If Lawsuit Ends Federal Mandates on Birth Control Coverage, States Will Have the Say An ongoing lawsuit aims to set aside the Affordable Care Act’s requirements that insurers cover preventive care, such as contraception. If that happens, state reproductive health laws — varying across the country — would carry more weight, resuming the “wild West” dynamic from before Obamacare.
POSTED JULY 09, 2024 9:00 AM |
Lack of Affordability Tops Older Americans’ List of Health Care Worries Rising health care costs are fueling anxiety among older Americans covered by Medicare. They’re right to be concerned.
POSTED JULY 03, 2024 9:00 AM |
An Arm and a Leg: Meet the Middleman’s Middleman Why are patients facing bigger bills than they expect for out-of-network care? In this episode of “An Arm and a Leg,” the show explains the hidden mechanics of MultiPlan, a data firm that helps health insurers set these rates and make bigger returns.
POSTED JUNE 25, 2024 9:00 AM |
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