The health insurance marketplace is also known as the health insurance exchange. It is an online/physical place where people in the United States can purchase various types of health insurance plans and get the appropriate subsidies that are fixed based on income. In each state, there is one official health insurance marketplace. This may be run by the state, the federal government, or both.
In most states, the official marketplace for health insurance is Healthcare.gov. The health insurance marketplace was created in 2010 by the Affordable Care Act, and it began to operate in 2013.
Consumers can select from among various private health insurance providers that offer qualified health plans through the health insurance marketplace. All qualified plans must conform to the ACA standards. These standards are created and enforced by the federal government.
This means if you shop for a health plan at the health insurance marketplace, the insurer cannot use medical underwriting or deny your application based on pre-existing conditions. All the health plans on the marketplace cover the Affordable Care Act’s essential benefits without lifetime benefits or annual caps. Health plans with income-based subsidies and cost-sharing are only available on the marketplace and are important in making health insurance plans affordable for people with low income.
Who is Eligible?
Most people are eligible to use the health insurance marketplace, except for people enrolled in Medicare. The health insurance marketplace was designed for uninsured individuals or people purchasing their own health insurance to get healthcare coverage. People who are self-employed or employed at a place that does not offer health benefits can use the health insurance marketplace.
Also, people who retired before age 65 and are not eligible to receive Medicare can use the marketplace. Many non-elderly citizens get healthcare coverage from their employer and may not need to use the marketplace if they are comfortable with their employee health plan. However, they have the freedom to choose a plan in the healthcare insurance marketplace and drop their employer’s health coverage. People who fall under this category will not be eligible to receive financial assistance unless the employee health plan is determined to be unaffordable.
People who are non-elderly and are eligible for Medicaid can enroll in Medicaid through the marketplace or use the marketplace to determine their eligibility. The enrollment process for Medicaid is completed through the marketplace in some states.
Types of Health Insurance Marketplaces
Health insurance marketplaces are operated by states, the federal government, or both. As of 2021, there are 14 state-run marketplaces. These 14 states run the marketplace and have separate websites and call centers. Twenty-four states use federal government-owned marketplaces.
These states use the healthcare.gov website and the customer service center. Six states use the federal platform but have state-based marketplaces. These states run their own marketplace but use Healthcare.gov for enrollment. The remaining six states are in partnership with the federal government. However, the states have more oversight and are more involved in managing the marketplace. These states still rely on Healthcare.gov for enrollment.
For more information about the health insurance marketplace, reach out to Remco Insurance Services today. We can help you find a health insurance policy that is right for you!
