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Health Care Reform:

Health Insurance & Affordable Care Act

How to Use a Health Insurance Marketplace: FAQ

You're required by law to have health insurance by 2014. If you don't, you'll have to pay a penalty. So what do you do now? First, check out your state's health insurance Marketplace, also known as an Exchange. At the Marketplace, you can compare insurance plans and pick one that fits your needs and your budget.

Is the Marketplace for me?

Anyone can use a Marketplace to check out insurance options. You can use it if you’re deciding about insurance for the first time. And you can use it if you already have insurance.

But if you can get health insurance at work, that health plan may be your best choice. If you're like many people, the health insurance provided by an employer is more generous that what you could find on your state's Marketplace. That's particularly true if you work for a large company or if your income is more than about $90,000 for a family of four.

To buy insurance through the Marketplace, you must:

  • Live in the United States
  • Be a U.S. citizen or U.S. national or be in the country legally
  • Not be in jail

If you use Medicaid, you don't need to use your state's Marketplace. Some states are expanding Medicaid to cover more people. When you put in your information in your state's Marketplace, you'll be told if you're eligible for Medicaid.

If I haven't had health insurance and I have to buy it now, do I have to use the Marketplace?

No. The Marketplace will make it easier to find a qualified health plan at the lowest cost. But you can still buy insurance for yourself or your family outside of the Marketplace.

For instance, you can use an insurance web site or a broker to find a plan. If your company offers health insurance, consider it first.

Are there any benefits I get from buying health insurance from the Marketplace?

Some types of financial aid are only available through a Marketplace.

A tax credit is a new type of financial support that is sent directly to the insurance company to lower your monthly payment, called the premium.

How much you're eligible for depends on how much money you make each year and how many people are in your family.  Generally, the tax credit is available to:

  • Single people who make up to about $40,000 a year
  • A family of four if you make up to about $90,000 a year

To get an estimate of how much your insurance premium will cost, see WebMD's Insurance Cost Calculator. Online tools called subsidy calculators can estimate the amount of tax credit you are eligible for. On your state's Marketplace, you'll find out the exact amount.

A cost-sharing subsidy is an extra piece of financial help, in addition to a tax credit. It's for people in certain income levels. If you qualify, your deductibles, copays, and coinsurance will be lower.

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