Health Insurance Marketplace

How Marketplace Works?

The Health Insurance Marketplace, also called health exchange, is an organization set up to facilitate the purchase of health insurance in each state in accordance with the Affordable Care Act (ACA). The federal government operates the Federally Facilitated Marketplace, available at healthcare.gov. Some Sates elected to create their own Marketplaces. In Florida, we utilize the Federally Facilitated Marketplace. The Marketplace is a resource where individuals and families can compare and enroll in health insurance plans and get answers about their health care coverage.

Health-insurance-marketplace

What kind of Insurance is on the Marketplace?

  • Private health insurance. Plans cover essential health benefits, pre-existing conditions, and preventive care.
  • Lower costs based on your household size and income. You can preview plans available in your area right now, with prices based on your income and household size. Most people who apply will qualify for lower costs.

Enrollment Periods:

Annual Enrollment Period: Typically, the Annual Enrollment period runs from November 1st to December 15th for January 1st effective dates. Individuals may also qualify for Special Enrollment Periods outside of Annual Enrollment if they experience certain events. (See Special Enrollment Period and Qualifying Life Event).

Special Enrollment Period: A Special Enrollment Period (SEP) is a time outside of the annual enrollment period during which you and your family have a right to sign up for health coverage. The SEP opens when you experience a Qualifying Event (see below) and closes 60 days after that Event. You only have the 60-day window to purchase a plan.

Qualifying Life Event: A Qualifying Event is a change in your life that can make you eligible for a Special Enrollment Period to enroll in health coverage. Examples of qualifying life events are you lose your health insurance because you move to a new state, you lose your health insurance because you lost your job, and loss of health insurance due to changes in your family size (for example, if you marry, divorce, or have a baby).

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