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A consumer’s guide to the new Health Insurance Marketplace

Published: 2:05 pm CDT, September 30, 2013

This week marks the opening of the new Health Insurance Marketplace, which provides a single location for consumers to check out their health insurance options.

Whether you are uninsured and deciding about health insurance for the first time or already insured and trying to find better, more affordable coverage, the Marketplace offers one-stop shopping to compare options and choose which plan fits best.

Who can use the Marketplace? You are eligible if you are  a  U.S. citizen or lawful U.S. resident in need of insurance. Anyone currently incarcerated is not eligible.

Most Americans  who are currently uninsured will qualify for financial assistance through the Marketplace. No one is required to use the Marketplace to buy coverage, but for many, the Marketplace will make it easier to find the right plan.

If a small business with 50 or fewer full-time employees has not previously provided insurance to employees or if the business is looking to obtain a better deal on coverage, the Marketplace offers choices. Small business owners can shop, compare a variety of health insurance options and find a plan at competitive rates.

Individuals who already have affordable health insurance can keep their coverage and do not have to switch to coverage provided by the Marketplace.  Also, most Americans who currently have health insurance coverage through their jobs will continue to be covered under those plans. Similarly, people who are covered by Medicare will continue being covered through the program and are not able to use the Marketplace to buy Medicare supplemental – ”Medigap” — insurance. Individuals who are currently covered by Medicaid, TRICARE or other governmental plans will continue to be insured through their existing plans.

People currently with workplace coverage may also shop for better, more affordable coverage through the Marketplace if their employer plan is either too expensive or doesn’t provide a minimum level of coverage. An individual can qualify for financial assistance if their share of their employer’s coverage costs more than 9.5 percent  of their annual income or if the employer’s plan pays for less than 60 percent of the costs for services covered by the plan. Individuals who aren’t sure if their coverage is considered unaffordable or whether it meets the 60 percent  minimum value requirement should check with their company’s human resources department.

The Marketplace, a certified insurance Navigator, insurance broker or agent should also be able to help determine whether a consumer is eligible for coverage through the Marketplace.  

For more information: 

Photo courtesy of Rachel Frank/Corbis