F. A. Q

Frequently Asked Questions

The following items are the few documents/information you must bring. The Marketplace requires these documents to create an account, verify your identity, estimate your income, and see how much financial assistance you qualify for:

  • (If applicable) Previous year’s Marketplace enrollment information and healthcare.gov username and password
  • Your best estimate of what your household income will be this year, including employer and income information for every member of your household (for example, from pay stubs, income verification letter from employer, or W-2 forms/tax returns)
  • Home and/or mailing address for everyone applying for coverage
  • Information about everyone applying for coverage, like Social Security numbers and birth dates
  • List of current doctors/providers/medication (If applicable)
  • Immigration documents (I-94, green card) (If applicable)

If offered job-based coverage, you could enroll in a Marketplace plan, but you won’t qualify for financial assistance or other savings. You won’t qualify for protection if the job-based plan is affordable and meets minimum standards. Most job-based plans meet these standards.

For 2021 coverage, the Health Insurance Marketplace defines affordable job-based coverage as 9.83% or less of an employee’s household income (which may fluctuate each year). This information applies only to the employee and not their family, which means that if employer-based coverage is affordable for just the employee, it is reasonable for the whole family, regardless of additional costs. If coverage is considered affordable, family members can either pay the total price in the individual market or the amount the employer requires to cover the family on the employer’s plan.

Open enrollment is from November 1 to December 15 every year. If you miss the open enrollment window, you may still be eligible to enroll in Marketplace coverage if you experience specific life changes. For example, getting married, having a child, changing income, or moving could qualify you to enroll outside the open enrollment window.

For more information on Special Enrollment Periods, click here.

Once you’ve submitted your application to the Marketplace, you must pay your premiums to your health insurance company and premiums must be paid each month to ensure your coverage isn’t cancelled.

If you’re having issues with the online payment option, or if you have payment or general questions, you can contact your insurance company over the phone.

If you are a lawfully present immigrant, yes you can. Click here to see a list of eligible immigration statuses. If you are a lawfully present immigrant who has been denied Medicaid because you’ve been in the country less than five years, you may be able to get help paying for your coverage even if you don’t meet the income requirements.

If you’re a veteran and enrolled in TRICARE or the Veterans health care program, you’re considered covered under the Affordable Care Act.

If you’re a veteran or a beneficiary who is enrolled in a VA health care program and if you have dependents who aren’t eligible for a VA health care program, they can get coverage through the Health Insurance Marketplace.

Click here for more information on health coverage options for military veterans.