Before you sign and submit your application for coverage, you’ll be asked to check that you agree or disagree with a few agreement statements (also called "attestations"). Depending on your application information, you may not see all of these attestations. If you disagree with any of the attestations, you may be asked to provide additional information.

Learn how to get free or low-cost health care and dental care at your community health center even with no insurance.

Learn about your options under the Health Care Consumer Assistance Program at Healthcare.gov. Read about Obamacare and the choices it affords you today

Someone on your application who’s applying for coverage may be eligible for Medicaid or the Children's Health Insurance Program (CHIP), but because of eligibility requirements in the state related to eligible immigration status, he or she must have enough work history to qualify. The person can provide the Social Security Number (SSN) of a parent or spouse so we can also check their work history. This won’t have any impact on anyone’s immigration status. If you have questions about your work history record or need to correct your work history, call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.

If you want to give your SSN, enter your 9-digit SSN. We’ll verify it with Social Security, based on the consent you gave at the start of your application. If you don’t have an SSN, leave the field blank. Don’t enter ITINs or other numbers here.

You may be asked if any of the people on your application want us to send their information to their state Medicaid agency, so they can check on their Medicaid and/or Children's Health Insurance Program (CHIP) eligibility: This question is asking if you want the Medicaid agency to review your application and make a decision about your eligibility. You may qualify to get more health services and pay less for your care. You could also get help paying for past medical bills.

If a question asks you about “someone else who isn’t applying for health coverage,” check the box if there’s anyone in your household you haven’t told us about yet. This person may be submitting his or her own Marketplace application or might already have health coverage. We’ll need to know about all the people in your household to tell you how much help people who do want health coverage can get. We won’t ask about citizenship or immigration for household members who don’t want health coverage. It’s also optional for you to tell us their Social Security numbers (SSNs), although entering their SSNs could speed up the process for family members who do want help paying for coverage.

Even working families can pay less for health coverage. You may be eligible for a free or low-cost plan or a tax credit that can be used to lower your monthly premiums right away. See below for more information on these types of help. You’ll answer questions to see if you qualify for a break on costs.

Even if your income may be too high to get help paying for health coverage, you can still get a good deal on coverage through the Marketplace, and you won’t pay higher costs for pre-existing conditions. Pre-existing conditions are health problems a person has before the date a new health insurance policy starts. You can’t be charged more because of a pre-existing condition when you get coverage through the Marketplace.

If you’re offered a state employee health benefit plan through a job or a family member’s job, select “Yes.” Most people who work for the state or local government have the option to be covered through the state employee health benefit plan. These workers can usually cover their spouses and children through the plan. People who work at state universities may also be able to get this plan. If you could get a state employee plan because of your job or your relative’s job, select “Yes.”

If your coverage ended, you may be asked why. We’re asking this because sometimes children have a waiting period between ending employer-sponsored coverage and starting coverage through the Children’s Health Insurance Program (CHIP). There may be exceptions to that waiting period, based on the reason that the employer-sponsored coverage ended.

Entering this information will help the U.S. Department of Health and Human Services (HHS) better understand and improve the health and health care for all Americans. Providing this information won’t impact your eligibility for health coverage, your health plan options, or your costs in any way.

Where you live can affect what health coverage you’re eligible for as well as your eligibility to get help paying for coverage. You must be a resident in the state where you’re applying for coverage.