Tips for the Health Insurance Marketplace APP

If you don’t have health insurance through a job, Medicare, Medicaid, the Children's Health Insurance Program (CHIP), or another qualifying source, you can find coverage through the Marketplace.

Who Can Get Marketplace Coverage?

Open Enrollment Period

• • Dates: November 1 – January 15
  • Enroll by December 15: Coverage starts January 1
  • Enroll by January 15: Coverage starts February 1

Outside Open Enrollment

• You can get or change coverage only if you:
  • Experience a qualifying life change or income adjustment for a Special Enrollment Period.
  • Qualify for Medicaid or CHIP, which you can enroll in at any time, with coverage starting immediately. Learn more about these programs.

Most People Qualify for Savings

• Depending on your estimated household income, you may qualify for:
  • Lower monthly premiums through a premium tax credit.
  • Extra savings on out-of-pocket costs such as deductibles, copayments, and coinsurance.
  • Medicaid or CHIP coverage, which might include CHIP coverage for your children, even if you don’t qualify for Medicaid. See if you might save.

Coverage Includes

• All Marketplace plans cover:
  • 10 essential health benefits, including prescription drugs, emergency services, hospitalization, laboratory services, and mental health and substance use disorder services.
  • Free preventive health services at no cost when delivered by a doctor or provider in your plan’s network.
  • Coverage for pre-existing conditions.

How to Apply for Coverage

• Apply in the way that suits you best:
  • Online
  • By phone
  • With assistance from a community representative
  • Through an agent/broker
  • Via certified enrollment partner websites
  • With a paper application
    Apply now and review ways to apply. Use this checklist to gather necessary documents.

Don’t Forget to Pay Your Premium

• With Marketplace insurance, pay your monthly premiums directly to the insurance company, not to the Marketplace. Coverage begins only after your first premium payment. Get more information on completing your enrollment.

Getting a Health Insurance Marketplace APP Plan: 4 Simple Steps

Notice: You can get health coverage now if you qualify for:

• A Special Enrollment Period due to a life event or income change.
• Free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP).

Check if you qualify and follow these 4 steps to apply and enroll. Already have an account? Log in here to apply.

Before You Start: Key Resources

• Discover what Marketplace plans cover, including treatment for pre-existing conditions and essential health benefits.
• Preview health plans and prices to estimate costs. 

1. Create a Marketplace Account

• Provide basic information, such as your name, address, and email address to get started.
• If your state operates its own Marketplace, we’ll direct you there. Create Account

2. Prepare to Apply

• Learn how to get ready and gather necessary documents using this checklist (PDF, 189 KB).
• Estimate your income for your application.
• Need help? Explore ways to apply for health coverage.

3. Get Your “Eligibility Results”

• Submit your application to see if you qualify for:
  • A Marketplace health insurance plan with savings, such as premium tax credits to lower monthly premiums and reduced out-of-pocket costs.
  • Free or low-cost coverage through Medicaid and CHIP.
• See if you might save before you apply.

4. Enroll in Health Coverage

• Compare available health plans and prices in your area and choose the one that best fits your needs.
• Pay your premium directly to the insurance company to activate your coverage.
• Ready to apply and enroll?

After Enrollment:

• You’ll receive a packet with your new insurance card and details about your plan. Start using your coverage.
• Make updates if you move, have a baby, or adopt a child.
• If your income or household situation changes, update your application promptly, as it may affect your coverage options and savings.
• For Medicaid or CHIP, your state will provide information and next steps.

Are You Eligible for the Marketplace?

To enroll in health coverage through the Marketplace, you must:

• Live in the United States (U.S.).
• Be a U.S. citizen, national, or lawfully present non-citizen. Learn about eligible immigration statuses.
• Not be currently incarcerated.
• If you have Medicare coverage, you cannot enroll in a Marketplace health or dental plan. Learn more about Medicare and the Marketplace.

What Does “Live in the U.S.” Mean?

• If you are considered a U.S. “resident” for tax purposes, you are eligible for Marketplace coverage. Learn more about what the IRS considers a resident.
• Marketplace insurance covers care provided by doctors, hospitals, and other providers within the U.S., so this is important if you reside outside the U.S.

Who is Considered a U.S. National?

• A U.S. national is someone who is either a U.S. citizen or owes permanent allegiance to the U.S. Non-citizen U.S. nationals are typically individuals born in American Samoa or abroad to American Samoan parents.

What If I’m a Resident of a U.S. Territory?

• If you live in a U.S. territory, you cannot get health coverage through the Marketplace unless you also qualify as a resident of one of the 50 states or Washington, DC.
• For information on Medicaid, the Children’s Health Insurance Program (CHIP), and other health care options in your territory, check with your local government offices.

When Can You Get Health Insurance?

Notice: You can get health coverage now if you qualify for:

• A Special Enrollment Period due to a life event or income change.
• Free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP).

Check if you qualify.

Important Dates:

• November 1: Open Enrollment begins. This is the first day you can enroll in, renew, or change your Marketplace health plans. Coverage can start as soon as January 1.
• December 15: Last day to enroll in or change plans for coverage to begin January 1.
• January 1: Coverage starts for those who enrolled or changed plans by December 15 and paid their first premium.
• January 15: Open Enrollment ends. This is the last day to enroll in or change Marketplace health plans for the year. After this date, you can only enroll or change plans if you qualify for a Special Enrollment Period.
• February 1: Coverage starts for those who enrolled or changed plans between December 16 and January 15 and paid their first premium.

Get Coverage Between January 16 and October 31: You can enroll if you qualify for a Special Enrollment Period due to a life event or income change. You can also apply for free or low-cost coverage through Medicaid or CHIP at any time. Check if you qualify.

What’s Next?

• Preview plans and prices.
• Sign up for email reminders so you never miss important information.