01Step one
Start with your ZIP code
Marketplace plans are sold county by county, and your county determines which insurers, networks, and prices you see. Everything else follows from this.
Enrolling
Four steps, and one that people forget.
Enrolling in a marketplace plan is mostly gathering a few facts about your household. The step that trips people up is the last one: coverage starts when the first premium is paid.
Enroll during Open Enrollment, or with a life eventOpen Enrollment runs November 1 through January 15 in most states. Outside that window you need a qualifying life event such as losing other coverage, moving, marriage, or a birth, and you generally have 60 days to enroll.
The steps
What enrolling actually involves.
02Step two
Describe your household and income
Who is on the application, who is claimed on your tax return, and what you expect to earn this year. That is what determines eligibility for savings, Medicaid, or CHIP.
03Step three
Compare plans on more than premium
Check the deductible, the out-of-pocket maximum, your doctors, and your prescriptions. The cheapest premium and the cheapest year are often different plans.
04Step four
Enroll, then pay the first premium
Coverage is not active until the first premium is paid, by the deadline the insurer sets. This is the step people most often forget, and it is the one that starts the coverage.
Before you start
What to have in front of you.
The application asks about your household, your income for the coverage year, and any coverage offered through a job. Having these on hand is the difference between finishing in one sitting and coming back to it twice.
- Home address and ZIP code for everyone applying, plus mailing address if it differs
- Dates of birth and Social Security numbers for household members who have one
- Document numbers for lawfully present immigrants who are applying
- Your best estimate of household income for the coverage year, with recent pay stubs, a W-2, or self-employment records to check it against
- Information about any health coverage available through a job, including the employer coverage notice if you have one
- Names of the doctors and hospital you want to keep, and a list of your prescriptions
After you enroll
Six things that make the coverage real.
- Pay the first premium by the insurer deadline. Coverage does not begin until that payment is made.
- Watch for your member ID card and the plan welcome materials, and create your account on the insurer site.
- Confirm with your doctor offices that they accept the specific plan and network for the new plan year.
- Move any prescriptions to a pharmacy in the plan network, and check whether a preferred pharmacy costs less.
- Report income, address, or household changes to the marketplace during the year so your savings stay accurate.
- Keep the Form 1095-A the marketplace sends in the new year. You need it to file your federal tax return.
At a glance
Dates that decide your start date.
- Open Enrollment begins in most states
- Nov 1
- usual deadline for coverage starting January 1
- Dec 15
- Open Enrollment ends in most states
- Jan 15
- to enroll after a qualifying life event
- 60 days
Good to know
Questions people ask about enrolling.
How long does enrolling take?
Most people finish in well under an hour when they have their household and income details ready. What slows it down is stopping partway through to look up an income figure or a Social Security number, so gather those before you start.
Does it cost more to enroll with help?
No. Marketplace premiums are set by the insurer and filed with regulators, so the same plan costs the same whether you enroll on your own, through the marketplace, or with a licensed agent. Working with an agent costs you nothing extra.
When does my coverage start?
It depends on when you enroll. During Open Enrollment in most states, enrolling by December 15 means coverage starting January 1, and enrolling between December 16 and January 15 means coverage starting February 1. With a Special Enrollment Period, the start date depends on the qualifying event and when you pick a plan.
Can I change my plan after I enroll?
You can change plans freely until Open Enrollment closes. After that, you generally need a qualifying life event to switch. Choosing carefully the first time matters more than it might seem, because the plan you pick is usually the plan you keep for the year.
What if I am not eligible for a marketplace plan?
You may be eligible for Medicaid or CHIP, which accept applications all year, or for coverage through a job, a spouse, or a parent plan if you are under 26. If you are 65 or older or otherwise eligible for Medicare, that is usually the right program instead.
Get started
See the plans you can enroll in today.
Enter your ZIP code to compare marketplace coverage, with a licensed agent available if you want help.