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What is the Health Insurance Marketplace and Who is Eligible?

The Health Insurance Marketplace is the government site for uninsured individuals to enroll in health insurance plans that offer reduced (subsidized) insurance premiums. Reduced premiums are based on income and household size.

A household (whether it is one person or more) must have an income above $17,420 to apply for subsidized health insurance premiums.

The Health Insurance Marketplace is a result of the 2010 Affordable Care Act (ACA).  One goal of the ACA is to help the uninsured, and those with pre-existing health conditions access affordable health insurance.

Since 2019, the Affordable Care Act (ACA) no longer requires everyone to carry health insurance or pay a tax penalty.

Also, the ACA ensures that all insurance plans allow parents to include their children on their health insurance plans up to age 26 and provide ten essential services:

  1. Preventive and wellness visits, including chronic disease management
  2. Maternity and newborn care
  3. Mental and behavioral health treatment
  4. Services and devices to help people with injuries, disabilities, or chronic conditions
  5. Lab tests
  6. Pediatric care
  7. Prescription drugs
  8. Outpatient care
  9. Emergency room services
  10. Hospitalization

If you are under age 65 without health insurance, you have through August 15 to enroll in or change your Health Insurance at the Marketplace®.

To receive the premium tax credit that lowers monthly premiums for a Marketplace health insurance plan, you must get your health insurance through the Health Insurance Marketplace. Income from employer, self-employment, social security, alimony (before 2019), pension, and household size are the main factors used to calculate your premium tax credit.

You can buy health insurance through other sources, but the only way to get a premium tax credit is through the Health Insurance Marketplace®.

For more information, go to Healthcare.gov or call 1-800-318-2596.

Source: Healthcare.gov

The Savvy Consumer is a monthly educational publication created by Meg McAlpine, University of Florida/IFAS, Nassau County Extension Service (904)-570-5713

The Institute of Food and Agricultural Sciences (IFAS) is an Equal Opportunity Institution authorized to provide research, educational information and other services only to individuals and institutions that function with non-discrimination with respect to race, creed, color, religion, age, disability, sex, sexual orientation, marital status, national origin, political opinions or affiliations