Health Insurance Marketplaces

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HHS Launches Health Insurance Marketplace Educational Tools

On June 24, 2013, the Obama administration announced its launch of the Health Insurance Marketplace education effort with a new, consumer-focused HealthCare.gov website and the 24-hours-a-day consumer call center to help Americans prepare for open enrollment and ultimately sign up for private health insurance. The new tools will help Americans understand their choices and select the coverage that best suits their needs when open enrollment in the new Health Insurance Marketplace began October 1, 2013. Americans may now access new educational information and learn what they can do to begin to get ready for open enrollment this fall. The website will add functionality over the summer so that, by October, consumers will be able to create accounts, complete an online application, and shop for qualified health plans. For Spanish speaking consumers, CuidadoDeSalud.gov will also be updated to match HealthCare.gov's new consumer focus.

Open enrollment for the Marketplace startsed October 1, 2013. Plans and prices will be available online or in-person. Coverage starts as soon as January 1, 2014.

Health Insurance Marketplace

From the official Marketplace website: www.Healthcare.gov

The Marketplace is a new way to find health coverage that fits with users’ budget and needs. The key features include: 

Medicare Beneficiaries

Medicare is not part of the Health Insurance Marketplace. If a beneficiary has Medicare, whether through Original Medicare or a Medicare Advantage Plan, he/she is already covered by health insurance, and it is generally not to their advantage to join the Marketplace. The Marketplace will not affect Medicare choices, and Medicare benefits will not change based on developments with the Marketplace. However, Medicare beneficiaries, are free to compare their health insurance coverage with plans offered in the Marketplace, and switch from Medicare coverage if they choose (though this is not recommended).

Compare Options in the Health Insurance Marketplace

Insurance plans in the Marketplace are offered by private companies, and they cover the same core set of benefits called essential health benefits. No plan can turn a beneficiary away or charge based on illness or medical condition. They must cover treatments for these conditions. Plans also cannot charge women more than men for the same plan.

Find Your State's Marketplace

Marketplaces are run by either a particular state, or the federal government. Each state has chosen to operate one of the following:

  • State-Based Exchange: The state creates and runs its own Marketplace
  • State-Federal Partnership: The state partners with the Federal government to run some Marketplace functions
  • Federally-Facilitated Exchange: The state has a Marketplace established and operated by the Federal Government

Click here to find out if your state is operating the Marketplace and get state-specific information using the menu on the official Marketplace website. If your state runs its own Marketplace, you must follow the link provided to get health coverage through your state’s website.

Find Live and Online Assistance in Your State

Users can compare plans with a Marketplace Navigator, or other assistance personnel specific to your state. They will help you compare plans based on price, benefits, quality, and other features before making important health care choices.

Use the Find Local Help tool in states that have a Federally-Facilitated Marketplaces and State-Partnership Marketplaces on Healthcare.gov. If the state has its own State-Based Marketplace, the user will be informed of this when they put a zip code into the search box in the Find Local Help tool noted above, and will be given a link to their state’s Marketplace website.  All I&R/A staff are encouraged to become familiar with the Marketplace assistance personnel that cover your organization’s area.

Click here for a CMS factsheet to understand the difference between Navigators, Non-Navigator In-Person Assisters, Certified Application Counselors, and Agents/Brokers.

Get help online, by phone, by chat, or in person

Phone 1-800-318-2596, 24 hours a day, 7 days a week (TTY: 1-855-889-4325)