Health Insurance Essentials

Get information about your health insurance options and the Health Insurance Marketplace® at Healthcare.gov

Getting regular medical care

Most health plans give you the best deal on services when you see a doctor who has a contract with your health plan. While you may be able to see doctors who don’t contract with your plan, visiting an “in-network” provider usually means you’ll have lower out-of-pocket costs.

No disability benefits, no health coverage

If you have a disability, don’t qualify for disability benefits, and need health coverage, you have options in the Health Insurance Marketplace®.

Exemptions from the requirement to have health insurance

Most people must have qualifying health coverage or pay a fee for the months they don’t have insurance. But if you qualify for a health coverage exemption you don’t have to pay the fee

Medicaid & CHIP for American Indians and Alaska Natives

Medicaid and the Children’s Health Insurance Program (CHIP) are available for qualifying American Indians and Alaska Natives. Find out if you’re eligible at Healthcare.gov.

After you submit your documents

What to expect after you submit verification information. Find out how & when Marketplace will respond, confirm health coverage. Links to contact info

Agents & Brokers: Sell Marketplace health insurance for 2022

Get ready to sell health and dental plans to individuals, families, and small businesses through the Health Insurance Marketplace®. Just register, complete brief training, and start selling.

The Marketplace application and disabilities

When you fill out an application for coverage from the Health Insurance Marketplace®, you’ll be asked several questions about disabilities. Get information to help you answer the questions.

Protection from employer retaliation

Learn about protection from employer retaliation if you buy a Marketplace health plan or report violations of the Affordable Care Act.

Doctor choice & emergency room access

You have the right to choose the doctor you want from your health plan’s provider network. You also can use an out-of-network emergency room without penalty.

Ending lifetime & yearly limits

The health care law stops insurance companies from limiting yearly or lifetime coverage expenses for essential health benefits.

Rights & protections

Whether you need health coverage or have it already, the health care law offers rights and protections that make coverage fairer and easier to understand.

Cracking down on frivolous cancellations

The health care law stops insurance companies from canceling your coverage just because you made a mistake on your insurance application.

Getting prescription medications

Health plans will help pay the cost of certain prescription medications. You may be able to buy other medications, but medications on your plan’s “formulary” (approved list) usually will be less expensive for you.

Rate Review & the 80/20 Rule

The health care law provides 2 new ways to hold insurance companies accountable and help keep your costs down: Rate Review and the 80/20 rule.

Getting emergency care

In an emergency, you should get care from the closest hospital that can help you. That hospital will treat you regardless of whether you have insurance.

Appealing an insurance company decision

If your health insurance company doesn’t pay for a specific health care provider or service, you have the right to appeal the decision and have it reviewed by an independent third party.

Web browser, cookie & cache settings

Best web browsers, how to set up browsers when applying in the Marketplace online

Filling out the Employer Appeal Request Form electronically

First download the form and then follow the steps to fill out an Employer Appeal Request Form (PDF).

HealthCare.gov Accessibility for People with Disabilities and Compliance with Section 508

Read about Accessibility and Compliance with Section 508 at Healthcare.gov. Learn how federal law requires access to information for the disabled


Loading

Updating Profile