Health Insurance Marketplace

The Health Insurance Marketplace, also known as the Exchange, is a service available in the United States that helps people shop for and enroll in affordable health insurance. The Marketplace was established by the Affordable Care Act (ACA), often referred to as "Obamacare." It offers a platform for individuals, families, and small businesses to compare and purchase health insurance plans.

Who has access?

  • 1: Individuals without employer-sponsored insurance

    Individuals who do not have access to affordable health insurance through an employer, or who are self-employed, can use the Marketplace to find a plan.

  • 2: Those not covered by other public insurance programs

    Individuals who are not eligible for other public insurance programs, such as Medicaid or the Children’s Health Insurance Program (CHIP), may find coverage through the Marketplace.

  • 3: Individuals not covered by Medicare

    Those who are eligible for or enrolled in Medicare cannot use the Marketplace to buy a health insurance plan. Instead, Medicare offers its own set of health plan options.

  • 4: Residents of the serving states and territories

    Individuals must live in the state or territory that the Marketplace serves to buy a plan from that Marketplace. Some states have their own Marketplaces, while others use the federal Marketplace.

  • 5: U.S. Citiznes or Lawful Residents

    Individuals who are U.S. citizens or lawful greencard holders can use the Marketplace to purchase health insurance.

✔ Plan Comparison

The Marketplace allows consumers to compare different health insurance plans based on price, benefits, quality, and other features important to them. It simplifies the process of finding a plan that fits their needs and budget.

✔ Financial Assistance

Depending on their income and family size, individuals may qualify for financial assistance to help pay for their insurance. This can include tax credits to lower monthly premiums and cost-sharing reductions to save on out-of-pocket costs like deductibles and copayments.

✔ Enrollment Periods

Generally, there is an annual Open Enrollment Period when people can enroll in a health insurance plan. However, special enrollment periods are available for those who experience certain life events, such as losing other health coverage, moving, getting married, or having a baby.

✔ Essential Health Benefits

All plans offered in the Marketplace must cover a set of essential health benefits, including services like emergency services, maternity care, mental health services, prescription drugs, and preventive services.

✔ State-Specific Marketplaces

While there is a federal Marketplace accessible through HealthCare.gov, some states operate their own Marketplace platforms. These state-specific Marketplaces provide tailored information and services to their residents.

✔ Medicaid and CHIP

The Marketplace also serves as a gateway for Medicaid and the Children's Health Insurance Program (CHIP), allowing individuals to check their eligibility for these programs and enroll if they qualify.

Our Carriers

There are 4 categories of health insurance plans: Bronze, Silver, Gold, and Platinum. These categories show how you and your plan share costs. Plan categories have nothing to do with quality of care.

Bronze Plan

Insurance pays 60% / You pay 40%

Silver Plan

Insurance pays 70% / You pay 30%

Gold Plan

Insurance pays 80% / You pay 20%

Platinum Plan

Insurance pays 90% / You pay 10%

Bronze

  • Lowest monthly premium.

    Highest costs when you need care.

  • The amount of medical costs you pay yourself before your insurance plan starts to pay — can be thousands of dollars a year.

  • Good choice if you want a low-cost way to protect yourself from worst-case medical scenarios, like serious sickness or injury. Your monthly premium will be low, but you’ll have to pay for most routine care yourself.

Silver

  • Moderate monthly premium.

    Moderate costs when you need care.

  • The costs you pay yourself before your plan pays anything — are usually lower than those of Bronze plans.

  • Good choice if you qualify for “extra savings” — or, if not, if you’re willing to pay a slightly higher monthly premium than Bronze to have more of your routine care covered.

Gold

  • High monthly premium.

    Low costs when you need care.

  • The amount of medical costs you pay yourself before your plan pays — are usually low.

  • Good choice if you’re willing to pay more each month to have more costs covered when you get medical treatment. If you use a lot of care, a Gold plan could be a good value.

Platinum

  • Highest monthly premium.

    Lowest costs when you get care.

  • Deductibles are very low, meaning your plan starts paying its share earlier than for other categories of plans.

  • Good choice if you usually use a lot of care and are willing to pay a high monthly premium, knowing nearly all other costs will be covered.

*In order to qualify for the Premium Tax Credit, you must be enrolled in a Silver, Gold, or Platinum plan. File form 8962 with Federal Tax Return to receive the credit- consult with a tax professional to determine additional income related eligibility requirements.