Skip to content
My WebMD Sign In, Sign Up

Health Care Reform:

Health Insurance & Affordable Care Act

How to Use a Health Insurance Marketplace: FAQ

How can the Marketplace save me money?

Health plans sold through a Marketplace have limits set on how much you have to pay for your health care each year. These limits were set by the Affordable Care Act.

Out-of-pocket limits: Out-of-pocket costs are what you pay for health care after you pay the monthly premium. You may pay deductibles, copays or coinsurance, and out-of-network payments.

An out-of-pocket limit is the amount a plan may set as the maximum amount you have to spend. If you reach that limit, the health plan pays 100% of the rest of your care.

When you buy insurance through the Marketplace, your plan will have an annual out-of-pocket limit. The limit should be no more than about $6,000 a year for one person and $12,000 for a family. These limits may be lower depending on your income. That means you will not have to spend as much of your own money to pay for health care.

Out-of-pocket limits are scheduled to increase each year under a formula included in the new law. The limits won't apply to insurance bought through work until 2015.

What if I can't afford to buy insurance, even through the Marketplace?

The Marketplace will have plans for different income levels. It will also help you find other programs you qualify for, like Medicaid or the State Children's Health Insurance Program. And it will help you sign up for them.

If you do not qualify for public aid and cannot afford to buy insurance on your own, you may apply for an exemption. If you're approved, you won't have to pay a fine for not having insurance.

How do I find the Marketplace in my state?

You can find a link to your state's Marketplace on WebMD's State Map.

How do I buy insurance through the Marketplace? When do I need to do it?

Once you find a plan on the Marketplace that fits your needs, you can enroll online. Or you can sign up by phone, by mail, or in person.  

Open enrollment runs until March 31, 2013.

I find this confusing. Is there anyone who can help me?

Each Marketplace will have people trained to help, called navigators. You'll be able to meet with them one-on-one at community centers, grocery stores, churches, and fairs. As it gets closer to October, your state will have exact information about where they'll be.

WebMD Medical Reference

Calculate
Your Costs

See insurance premium
costs and financial aid.

Start Here

Health Insurance
Advisor

Find a plan that's right
for you.

Start Here

Your State's Insurance Marketplace

Get informed about plans, benefits and costs.

From WebMD

Latest Health Reform News

Loading …
URAC: Accredited Health Web Site HONcode Seal AdChoices