How to Sign up for Health Insurance Under the Affordable Care Act
To sign up for ObamaCare find your state’s health insurance marketplace, sign up, then enroll. Sign up for ObamaCare during open enrollment.
Open Enrollment for Health Insurance
- 2016 Open Enrollment in the Health Insurance Marketplace (Healthcare.Gov) started November 1st, 2015 and ends January 31st, 2016.
- Open enrollment for 2015 started November 15th, 2014 and ended February 15th, 2015.
Open enrollment is the only time of year everyone can obtain Minimum Essential Coverage. Each health insurance type has its own enrollment period. Coverage options outside of open enrollment include qualifying for a Special Enrollment Period, Medicaid, and CHIP. If you don’t have access to these consider your Short Term Health Insurance options.
Renewing, Enrolling, and Verifying Info During Open Enrollment
Make sure to enroll, switch plans, and verify your cost assistance each year by December 15th for a plan starting Jan 1st. Your plan and cost assistance may or may not auto-renew on the 1st of the year. Even if you miss the deadline to get covered by Jan 1st, make sure to verify information, change plans, and/or enroll before the end of open enrollment.
Should I Use the Health Insurance Marketplace?
There are lots of ways to sign up for health insurance for 2016, including Private Options outside of the marketplace. While some non-marketplace options can help you find a marketplace plan, we always suggest making your state’s marketplace or Healthcare.Gov your first stop. The marketplace is the only way to get cost assistance on premiums and out-of-pocket costs. 24/7 marketplace assistance is available online, by phone, or in-person (details below).
After you know your marketplace options, compare them with health quotes outside the marketplace to understand all of your options. Keep reading for more facts to help you understand the sign up process for the Health Insurance Marketplace and other insurance types.
Options For Getting Covered Under ObamaCare
ObamaCare doesn’t eliminate private insurance – it just gives you more options for obtaining it. You can san still Shop For Coverage Outside The Marketplace. However, if you make between 100% – 400% of the Federal Poverty Level (FPL), your first stop should always be your state’s marketplace or the official marketplace HealthCare.Gov. The marketplace is the only way to qualify for cost assistance. As soon as you sign up you’ll find out if you are eligible. You can then compare plans (with cost assistance automatically applied) before enrolling.
Healthcare.gov is the official Health Insurance Marketplace for states that didn’t set up their own marketplace. Make your first stop the marketplace, and you will find out if you qualify for lower costs on coverage. Use other options, such as the form below, to get assistance outside the Marketplace as well as quotes from outside the marketplace.
Medicaid / CHIP, Medicare, and Employer Coverage
If you make less than 138% of the Federal Poverty Level (FPL) and your state expanded Medicaid, you may qualify for Medicaid. CHIP has even more eligibility options and is offered to children and parents. Medicaid and CHIP are offered 365 days a year.
If you qualify for Medicare you can’t sign up for ObamaCare or any other non-Medicare coverage, so you may want to look at supplemental Medicare options during Medicare’s open enrollment periods if original Medicare isn’t enough.
If you are offered coverage through an employer, you’ll most likely want to go that route, as you won’t be eligible for cost assistance on the Marketplace. Family members who have access to employer coverage can’t get cost assistance either. Your employer will have unique enrollment periods and special enrollment periods.
Remember each insurance type has its own open enrollment period – don’t confuse the enrollment period for private coverage for individuals and families with Medicaid, CHIP, Medicare, or Employer enrollment periods.
What You Need To Sign Up For ObamaCare
Make sure you have the following information about you and your family before visiting your State’s Health Insurance Market Place
• Last year’s tax information for you and your family
• Projected incomes for this year
• Medical history – ObamaCare does away with pre-existing conditions and gender discrimination, so these factors will no longer affect the cost of your insurance. Smoking, weight and age still affect cost.
• Social Security Numbers (or document numbers for legal immigrants)
• Employer and income information for every member of your household who needs coverage (for example, from pay stubs or W-2 forms—Wage and Tax Statements)
• Policy numbers for any current health insurance plans covering members of your household.
• A completed Employer Coverage Tool for every job-based plan you or someone in your household is eligible for. (You’ll need to fill out this form even for coverage you’re eligible for, but don’t enroll, in it.)
• Any other important information that could affect your health insurance premium or coverage options. Better safe than sorry!
Here is an example of the health insurance exchange application form for individuals.
Here is an example of the health insurance exchange application form for families.
Want more information on the marketplace and how to sign up? Check out our guide to the health insurance marketplace.
How to Sign Up For The Health Insurance Marketplace
Obviously you can use your State’s health insurance marketplace to sign up for private insurance, get access to subsidies, or apply for Medicaid or CHIP, but there are actually four ways to sign up including the website.
1) Find your State’s marketplace website.
2) Get in-person help. You can find in-person help by going to LocalHelp.Healthcare.gov.
3) Call the 24/7-marketplace helpline 1-800-318-2596.
How to Enroll in a Health Insurance Marketplace Plan
Here are the official directions for enrolling in a marketplace plan through Healthcare.Gov. Remember signing up is only step one – you still need to choose a plan and make your first payment for your coverage to begin officially. State-based marketplaces have very similar sign up and enrollment processes. The directions below are specifically for States running a federal-based marketplace (i.e. States using Healthcare.Gov as their marketplace).
- Set up an account. First you need to provide some basic information. Then choose a username, password, and security questions for added protection.
- Fill out the online application. You must provide information about you and your family including income, household size, current health coverage information, and more. This will help the Marketplace find options that meet your needs. Important: If your household files more than one tax return, call the Marketplace Call Center at 1-800-318-2596 before you start an application. (TTY: 1-855-889-4325) This is a very important step. Please don’t skip it. Representatives can provide directions to make sure your application is processed correctly.
- Compare your options. You’ll be able to see all the options you qualify for, including private insurance plans and free and low-cost coverage through Medicaid and the Children’s Health Insurance Program (CHIP). The Marketplace will tell you if you qualify for lower costs on your monthly premiums and out-of-pocket costs on deductibles, copayments, and coinsurance. You will see details on costs and benefits to help you choose a plan that’s right for you.
- Enroll. After you choose a plan, you can enroll online and decide how you pay your premiums to your insurance company. If you or members of your family qualify for Medicaid or CHIP, a representative will contact you to enroll. If you have any questions, there’s plenty of live and online help along the way.
Quick Facts About Signing Up for ObamaCare’s Health Insurance Marketplace
• Minimum essential coverage includes all marketplace coverage, most major medical Coverage Sold Outside The Marketplace, Medicare, Medicaid, employer based coverage, and more. It does not include short-term health insurance.
• You can’t buy or change plans outside open enrollment without qualifying for special enrollment.
• Plans purchased during open enrollment will end on December 31st of the year in which you are covered, so you will need to decide if you want to keep or change your plan during open enrollment of the next year, which in this case is 2015.
• Most Private Coverage Options outside open enrollment, like short-term health insurance, aren’t major medical plans and don’t count as minimum essential coverage. Short-term policies will provide health insurance as stated in the contracts, but don’t follow all of the rules and regulations of the Affordable Care Act, so they won’t protect you from the fee for not having insurance.
• Anyone can sign up for ObamaCare’s marketplace, but if you have access to insurance through your employer, qualify for Medicaid, CHIP, or Medicare, or make over 400% of the Federal Poverty Level, you won’t have access to cost assistance like tax credits for lower premiums or cost assistance subsidies for lower out-of-pocket costs.
• As of April 17th, 2014, over 8 million people have enrolled in private health plans through the State and Federal marketplaces and even more have enrolled in Medicaid. It is estimated that between 15-20 million people got covered during open enrollment 2014 through all insurance types. The goal for 2015 was to have 9.1 million people enrolled in marketplace plans, by the end of June 2015 9.9 million were still enrolled and paid. Learn more about ObamaCare’s enrollment numbers.
• Marketplace insurance purchased before the 15th of each month starts on the first of the following month after you have paid your premium.
ADVICE: Sign up for the marketplace ahead of time and make sure your account is up and running smoothly. Then you have until the end of open enrollment (or a special enrollment period if you qualify) to enroll in plan! Leaving the application process to the last minute could result in you missing your chance to get cost assistance until next open enrollment.
When Does ObamaCare Start?
- ObamaCare was signed into law in March of 2010.
- Many important provisions kicked in between 2010 and 2014 with the most important provisions like the fee for not having coverage and cost assistance through the Marketplace and Medicaid expansion started January 1st, 2014.
- Open enrollment in the marketplaces to buy subsidized private insurance for 2014 started on October 1st, 2013 and ended March 31st, 2014 for that year (extended to April 15th for those who qualify for a special enrollment).
- Open enrollment for 2015 started on November 15th, 2014 and ended February 15th, 2015.
- Open enrollment for 2016 starts on November 1st, 2015 and ends January 31st, 2016.
- Open enrollment dates are subject to change for each year moving forward.
- The law has required you to have health insurance since 2014 or pay a per-month fee for each month you go without coverage (although you are allowed up to three months in a row without coverage each year).
Signing Up For ObamaCare this year (Open Enrollment 2016)
The sign up process for marketplace insurance and Medicaid is the same each year, but dates are subject to change. Starting on November 1st, 2015 new and existing customers will have an opportunity to see what new plans are being offered in the marketplace for open enrollment 2016. All new plans start on January 1st, 2016 at the earliest. Customers with marketplace plans should verify their information to ensure they are getting access to any cost assistance they qualify for. In states that use auto-renew a customer may be switched to a different plan or different cost assistance amount atomically if they don’t make their own choice.
Check out our guide to Obamacare for more information on this year’s open enrollment period.
Who Is Eligible For ObamaCare Enrollment?
Any legal citizen, who does not qualify for Medicare, and who wants to purchase private insurance, is eligible for the marketplace. However, not everyone is eligible for subsidies. You can also sign up for Medicaid or CHIP through the marketplace. If you have employer based coverage, you’ll sign up through work. If you qualify for Medicare, you must sign up for Medicare separately.
If you’re eligible for job-based insurance, you can consider switching to a Marketplace plan. However, you won’t qualify for lower costs based on your income unless the job-based insurance fails to pay at least 50% of your premium, is unaffordable (9.5% of family income for employee only insurance), or doesn’t meet minimum requirements (must be equivalent of a bronze plan sold on the marketplace). You also may lose any contribution your employer makes to your premiums.
Medicaid Enrollment and CHIP Enrollment
You can enroll in Medicaid or CHIP 365 days a year! Medicaid coverage can start retroactively up to three months. If you want to make life easy and sign up for Medicaid or CHIP through the marketplace, you’ll have to sign up during open enrollment. If you miss open enrollment in the marketplace, you have other Medicaid sign up options.
Medicare isn’t part of the health insurance marketplace, if you would like to sign up for Original Medicare or supplemental Medicare, please see our page on Medicare Enrollment to learn how to sign up for Original Medicare, Medicare Advantage, Part D, and Medigap.
Enrollment Outside the Marketplace
If you project to make too much to qualify for cost assistance (more than $47,080 as an individual or $97,000 as a family of 4 in 2016), you may want to shop around for quotes outside the marketplace. By shopping Outside Of The Marketplace you’ll get access to a wider selection of plans, but you won’t be able to obtain cost assistance (although some brokers and providers can help you enroll in a marketplace plan or help you see if you qualify for cost assistance). As a rule of thumb, don’t shop outside the marketplace if you are eligible for cost assistance, but do shop for quotes both inside and outside the marketplace if you aren’t.
No matter how you get covered, you’ll still need to do so during open enrollment as all private insurers in the individual market have adopted ObamaCare’s open enrollment period.
Do I Have to Sign Up For ObamaCare?
You are considered covered if you have minimum essential coverage. Minimum essential coverage generally includes: all marketplace coverage, a private major medical insurance plan outside the marketplace (there are limitations), grandfathered health plans, Medicare, Medicaid, CHIP, COBRA, retiree coverage, TRICARE, VA health coverage, or some other kinds of health coverage.
Please see our ObamaCare exemptions page for a list of those who do not have to obtain coverage this year and annual grace periods.
When Can I Sign Up For ObamaCare?
You must sign up for ObamaCare during open enrollment. If you missed open enrollment, you will not be able to get private insurance inside or outside the marketplace unless you qualify for a special enrollment period.
ObamaCare Special Enrollment Period
A special enrollment period is a time outside the open enrollment period when you and your family can sign up for health insurance in the health insurance marketplace. You may qualify for a special enrollment period of 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage.
If you don’t have a special enrollment period, you can’t buy insurance inside or outside the Marketplace until the next open enrollment period.
ObamaCare Enrollment and Sign Up Advice
ObamaCare enrollment and sign up has to be done each year either during open enrollment or a special enrollment period in order to get insurance through the health insurance marketplace. Don’t leave signing up until the last minute. The process of creating an account and choosing the right health plan can be pretty time-consuming when done properly, and you’ll not only need to sign up, but also to enroll in a plan by the deadline.
Just creating an account needs patience and time. Circumstances such as missing a document or having the computer system be unable to verify your social security number can stop computer based enrollment in its tracks. You will then need to pick up the phone and try to talk to a person. Yikes! Although getting on the phone with a navigator can lead to a solution, the wait time is only going to increase as we move toward the last minute. The chances of running into an issue may be slim, but they do exist.
Once you get your account set up, you’ll need to shop for a health plan and enroll. Waiting until you must make a last-minute decision about your healthcare isn’t wise. When you start looking at plans, you’ll realize you have a lot of choices. You can check out our page on how to buy health insurance to get a better idea of what all the jargon means. Do yourself a favor and sign up early.
If you don’t plan to use the exchanges, most agents can help you pick the right plan for you and your family and, because agents are paid by the insurance company, a specific plan in a specific region will always cost the same amount no matter where you get it. If you would like help figuring out your insurance options, use the phone number on our site or go directly to your state’s marketplace and talk to one of their dedicated navigators or brokers.
Get Help Signing Up For Health Insurance
There are a number of ways to get help signing up for health insurance. We suggest the following methods unless you qualify for insurance through work, Medicare, TRICARE, or another type of non-private health insurance:
1. You can go directly to your state’s marketplace website and sign up. State marketplaces offer free help over the phone and in-person help for signing up. Details will be found below. Plans are limited to those sold on the marketplace in your area. If you think you qualify for Medicaid, please see our Medicaid page for more details. If you know you are eligible for cost assistance or Medicaid, this is a great option.
2. Go directly to a provider. You will see top providers listed on our site. You can sign up directly with a provider. Any provider will be able to sign you up for plans they sell in your state whether the plans are on or off the marketplace. If you know what plan you want or what provider you want to use, this is a great option.
3. Use a health insurance broker or agent. A broker or agent can help you sign up for the marketplaces and help you see if you qualify for cost assistance either online, in-person, or on the phone. Brokers and agents also have access to different plans from different providers – both inside and outside the marketplace. Brokers are paid by the insurance companies, so you won’t pay more by using this service. This is a great option if you aren’t sure if you qualify for cost assistance, or if you know that you don’t.
All providers and brokers listed on our site can help you to see if you qualify for cost assistance subsidies via your state’s marketplace. However, if you choose a plan that’s not offered on the marketplace, you won’t be able to get cost assistance. All plans sold on and off the marketplace are regulated, so you won’t pay more or less (barring cost assistance) no matter how you shop.
Sign Up For Cost Assistance Subsidies
You can use our subsidy calculator to see if you qualify for cost assistance on the marketplace and learn about your health care options both inside and outside of the marketplace at the same time. You can also simply find your state’s marketplace and fill out an application to see if you qualify for cost assistance subsidies. Cost assistance is only available through the Health Insurance Marketplace.
There are a few important ObamaCare deadlines everyone needs to know. Here is a quick breakdown of important ObamaCare deadlines for signing up for health insurance.
• October 1st, 2013 – ObamaCare’s health insurance marketplaces opened.
• December 24th, 2013 – The initial deadline to sign up for insurance that started as early as January 1st, 2014. In some States this deadline was pushed further out.
• January 1st, 2014 – A number of new benefits, rights and protections went into effect on all non-grandfathered insurance plans.
• January 1st to the 15th, 2013 – If you signed up for insurance that started before January 1st, 2014, you had to pay your premium before the first cut off date. Many insurance companies were giving customers up until the 10th or 15th of the month to pay their first premium.
• The 15th of each month (ending March 31st, 2014) – You had to sign up for insurance by the 15th of each month to have insurance that started the following month. If you signed up after the 15th, you needed to wait an extra month for your insurance to kick in.
• March 15th, 2014 – You were allowed up to three months in a row without coverage in 2013 due to a “coverage gap” exemption (before you owe a per-month fee for not having coverage). You needed to sign up for the marketplace by March 15th to meet this deadline.
• “Short Coverage Gap” Exemption(s) Update – Although the “short coverage gap” exemption allowed you up to three months in a row without coverage in 2014, healthcare.gov has stated that people had until March 31st, 2014 to enroll in a marketplace plan and still avoid the fee (due to an additional exemption that covered April). So you could have enrolled on March 31st and have coverage that started on May 1st and still avoided being responsible for the shared responsibility payment.
• March 31st, 2014 – Open enrollment for 2014 ended on March 31st, 2014. You could still sign up for off-marketplace insurance or Medicaid after open enrollment. Medicaid could start up to three months retroactively, while private insurance typically starts on the 1st of the following month if purchased before the 15th.
• Mid-April 2014 – If you signed up for the marketplace by March 31st, 2014 but weren’t able to enroll, you were still able to check a box that allowed you to enroll until mid-April due to a last-minute ObamaCare extension. There will be other opportunities for special enrollment periods for certain life events, but they required calling the official call center and requesting a special enrollment period.
• Certain life events like having a child or moving out of state can qualify you for a special enrollment period that allows you to purchase marketplace insurance outside of open enrollment with federal subsidies.
• November 31st, 2014 – Open enrollment for 2015 began for both the individual and small business portions of the marketplace. Small businesses have been eligible for tax credits for insuring employees since 2010. This needed to be done with the aid of an agent using a paper form for 2010-2014. Tax credits are retroactive. Learn more about ObamaCare and small business.
• December 15th, 2014 – Anyone who wanted their plan to start by January 1st, 2014 needed to take action to ensure they were renewing the plan they wanted for 2015. You could still change plans for the rest of open enrollment, but your plan would not start by January 1st.
• December 19th, 2014 – All plans eligible for auto-renew renewed for 2015.
• December 31st, 2014 – All plans enrolled in during last open enrollment ended.
• January 1st, 2015 – Plans that will be offered next year automatically renew with same cost assistance if applicable.
• February 15th, 2015 – This was the last day to enroll in a plan for 2015, change plans, or apply for cost assistance. This was true both inside and outside of the marketplace.
• November 1st, 2015: The first day of open enrollment for 2016 coverage.
• January 31, 2016: The last day of open enrollment for 2016 coverage.
• October 1st (moving forward into 2017): Open enrollment begins
• December 15th (moving forward into 2017): Open enrollment ends and plans auto-renew if applicable.
• January 1st (moving forward): All new plans, purchased or renewed before December 15 begin.
ObamaCare Deadline Extension
Each year there are different deadline extensions.
In 2014 there was an ObamaCare deadline extension for people who signed up for the health insurance marketplace, but were unable to enroll in a plan by the March 31 deadline. By checking a box upon logging in after April 1st, 2014 you were able to enroll in a plan until about mid-April. A similar extension was offered at the end of open enrollment 2015 and then again at tax time. Exact extensions can differ by state.
Extensions have been changing from year to year, but should not be expected. Special enrollment, on the other hand, will be offered each year.
ObamaCare Missed Deadline
If you miss the deadline for ObamaCare you still have options for coverage including a special enrollment period and options for obtaining Medicaid, CHIP, or health coverage outside of the marketplace. Check out our breakdown of what to do if you miss the ObamaCare deadline.
Coverage Gap Exemption During Open Enrollment
Under the Affordable Care Act you are allowed up to three month in a row without insurance due to a “coverage gap” exemption. This allows people who don’t have coverage to enroll in a plan all the way up until the end of open enrollment and still avoid the fee. However, those who take advantage of this won’t have the same flexibility as others if they lose coverage during the year, as they will have already used up their coverage gap.
ObamaCare Open Enrollment Reminder
Remember that open enrollment is the only time you can use the marketplace. Apply to the marketplace today and see if you qualify for subsidies. Insurance purchased through the marketplace before the 15th of each month starts on the 1st of the following month. If you want to avoid the fee make sure you enroll in coverage before the end of open enrollment each year.
If you miss open enrollment you won’t be able to enroll in a marketplace plan again until the next open enrollment period unless you qualify for a special enrollment period. Please note you can sign up for CHIP and Medicaid at any time, and up to three months retroactively if you qualify. Medicare and employer based insurance both have their own open enrollment and special enrollment periods as well.
Learn more about ObamaCare’s open enrollment to understand when you can sign up for different types of health insurance.
Other Ways to Sign Up For Insurance Under the Affordable Care Act
Aside from the marketplace, there are number of other options for getting coverage for 2015. Check out our guide to buying health insurance for 2015 to learn about more ways to sign up for insurance. You can also check out our guide to different types of plans sold on the health insurance marketplace.
How to: ObamaCare Sign Up