Walker Insurance Solutions, LLC
Brought to you by Walker Insurance Solutions, LLC
Call Us Today!
800-883-0902

Blog

  • Understanding regular vs. emergency health care

    It’s almost always best to get routine care and recommended preventive services from a primary care provider. There are big differences between visits to your primary care provider and emergency care.

    Image: Primary care vs. emergency care

    When to see your primary care provider

    • You’ll see your primary care provider both when you’re sick and when you’re well for regular care. They’ll get to know you and help track your health over time.
    • You can get primary care providers in doctors’ offices, clinics, and health centers nationwide.
    • Before you schedule your first appointment, contact your health plan to see how much you’ll have to pay for a primary care visit. The copayment for your visit may cost you between $0 and $50.

    When to seek emergency care

    • You should go to the emergency room only when you’re injured or very sick. You may wait several hours before you’re seen, and you’ll likely pay a larger copayment, co-insurance and have to meet your deductible before your health plan helps pay your costs.
    • Providers in the emergency room probably won’t have access to your health records.
    • Always in a life-threatening or emergency situation, call 9-1-1.

    See other differences between regular and emergency care.

  • Marketplace coverage & prescriptions: What you need to know

    All Marketplace plans cover prescription drugs. Fill any prescriptions you got from your doctor and take them as directed. Here are 3 things to know about filling prescriptions:

    Image: 3 things to know about filling drugs

    • You may have a prescription copayment. A copayment is the amount you owe for each prescription you fill. Copayments are usually between $0 and $50, depending on your insurance plan.
    • Check with your insurance company to see if you need preauthorization (also called “prior approval”). Your health plan may require preauthorization for certain drugs, unless it’s an emergency.
    • Different health plans allow you to get your medications from different pharmacies (called “in-network pharmacies”). Call your insurer, or visit their website to find out which pharmacies are in their network.

    Get more information on prescriptions and what to do when your drug isn’t covered.

  • Sending documents to confirm Special Enrollment Period eligibility

    If you applied for 2020 Marketplace coverage through a Special Enrollment Period, you may be asked to provide documents to confirm the life events that make you eligible. You must send them before you can start using your coverage.

    Image: {How to confirm Special Enrollment Period eligibility}

    You’ll learn if you have to provide documents after you submit your application. It’s best to pick a plan first and submit your documents afterwards. After you pick a plan, you usually have 30 days to send the documents.

    Documents & deadlines for your life event

    • The documents you can submit vary based on your life event.
    • Select your life event for the documents you can submit and key dates.

    How to submit documents

    • Provide the required documents as soon as possible after you pick a plan.
    • Doing so will prevent a delay in your coverage starting.
    • You can submit them online or copies by mail. Follow these steps.
    • After you submit them, you’ll get a letter or notice in your HealthCare.gov account within a couple of weeks saying if your Special Enrollment Period has been confirmed.

    Learn more about when the Marketplace needs documents to confirm a Special Enrollment Period.

  • Simple ways to use Marketplace coverage to improve your health

    Now that you have Marketplace health coverage, learn what you can do to stay healthy and get the care you need:

    Image: {Tips for staying healthy and getting proper care}

    Tips for staying healthy

    • Make time for physical activity, healthy eating, relaxation, and sleep.
    • Get the preventive services that are right for you.
    • Don’t forget to schedule follow-up visits. Ask your provider to notify you in advance when recommended health screenings should occur.
    • If you have questions or concerns between visits, just call your provider. It’s their job to help answer questions you have about your health.

    Tips for getting proper care

    • You can get health care many different places, including the emergency department. But it’s best to get routine care and recommended preventive services from a primary care provider. They’ll work with you to ensure you get the right services, manage chronic conditions, and improve your general health and well-being.
    • Generally, you can find primary care providers in offices, clinics, and health centers.
    • Not all types of providers and facilities take all insurance plans or types of coverage. Before you make an appointment, call the office to make sure they accept your coverage.

    Read the From Coverage to Care: Roadmap to Better Care and a Healthier You (PDF, 698 KB) for tips and information on putting your health first, knowing where to go for care, and preparing for appointments.

  • 5 things to know about tax Form 1095-A

    If anyone in your household had Marketplace health insurance in 2019, you should have already received Form 1095-A, Health Insurance Marketplace Statement, in the mail. Here are 5 important things to know about this form.

    Image: {Helpful tips about tax Form 1095-A}

    Helpful tips about tax Form 1095-A:

    • You should already have Form 1095-A. It comes from the Marketplace, not the IRS. If your form didn’t come by mail or you can’t find it, check your online Marketplace account before contacting the Marketplace Call Center.
    • Store it in a safe space with other important tax information, like W-2 forms. This way, you can easily find it when you sit down to file.
    • Before doing anything with the form, make sure it’s accurate. Check basic coverage and household member information, and confirm the premium for your second lowest cost Silver plan (SLCSP). Contact the Marketplace Call Center to report any errors.
    • If you request a new, updated form, it’s important that you don’t file until we send you the correct version. If you already filed, you may need to file an amended return using the information from your new 1095-A.
    • You’ll use the information from your 1095-A to “reconcile” your premium tax credit. To do this, you’ll compare the amount of premium tax credit you used in advance during the year against the premium tax credit you actually qualify for based on your final income for the year. Any difference will affect your refund or tax owed. See a step-by-step guide to “reconciling” your premium tax credit.

  • 3 things to know about coronavirus disease and your Marketplace coverage

    {% box %} Coronavirus.gov is the source for the latest information about COVID-19 prevention, symptoms, and answers to common questions.

    USA.gov has the latest information about what the U.S. Government is doing in response to COVID-19. {% endbox %}

    You may be hearing about the coronavirus (officially called 2019-novel coronavirus or COVID-19) in the news. Currently, the rules in your Marketplace health plan for treatment for COVID-19, remain the same as for the treatment of any other viral infection. Check with your health insurance company for their specific benefits and coverage policy. Here are some other things to know about how your Marketplace health plan works when it comes to coronavirus:

    Image: {3 things to know about coronavirus disease and your Marketplace coverage}

    Understanding your coverage

    • Lab and other services: Individual and small group market issuers are generally required to include laboratory services as a category of Essential Health Benefits. Coverage for a specific diagnostic or laboratory service can vary by plan, so check with your health insurance company about their coverage for lab tests and related services for diagnosis and treatment of COVID-19. This is also true for your health plan’s coverage for physician and hospital services related to the diagnosis and treatment of COVID-19.
    • Telehealth: Telehealth services or home health visits may already be covered by many health insurance companies. You should check with your health insurance company to determine whether these services are covered and what you’ll pay.
    • Enrolling in coverage: If you aren’t currently enrolled in coverage, you can see if you qualify for a Special Enrollment Period. As a reminder, federal law and regulations provide protections against pre-existing condition exclusions in health insurance coverage. If you are eligible, health plans must permit you to enroll regardless of health status, age, gender, or other factors that might predict the use of health services. Marketplace plans can’t terminate coverage due to a change in health status, including diagnosis or treatment of COVID-19.

    For more information about the Coronavirus, please visit: coronavirus.gov

  • Tips for “reconciling” your premium tax credit on 2019 taxes

    You have until April 15, 2020 to file your 2019 federal income tax return. If you had a Marketplace plan in 2019 and used advance payments of the premium tax credit (APTC) to lower your monthly payment, you’ll have to "reconcile" your tax return.

    Image: {How to "reconcile" your premium tax credit}

    Through “reconciling,” you’ll find out if there's any difference between the premium tax credit you used and the amount you qualify for. Any difference between the two figures will affect your refund or tax owed.

    How to "reconcile" your premium tax credit on 2019 taxes:

    1. Find your Form 1095-A, and verify its accuracy. If you didn’t get one, check your online Marketplace account. If it’s not there, try the Call Center. See how to be sure the information is correct.
    2. Print Form 8962 (PDF, 112 KB) and instructions (PDF, 356 KB).
    3. Use the information from your 1095-A form to complete Part II of Form 8962. Refer to this table as a guide.

    Get more information on 2019 health coverage and your federal taxes.

  • Recent life change? You may qualify for a Special Enrollment Period

    Now that Open Enrollment is over, you can enroll in or change Marketplace coverage only if you have a life event, like getting married, having a baby, or losing health coverage, that qualifies you for a Special Enrollment Period.

    What are the qualifying life events for Special Enrollment Period eligibility?

    Does my life event make me eligible for a Special Enrollment Period?

    There are 4 basic types of qualifying life events:

    • Loss of health coverage: Losing job-based coverage (whether through yourself or a family member) or eligibility for Medicaid, Medicare, or the Children’s Health Insurance Program (CHIP)
    • Household changes: Marriage, child birth or adoption, divorce, or death
    • Residence changes: Certain household moves, like moving to a new ZIP code or county
    • Other qualifying events (like income changes): Changes that make you no longer eligible for Medicaid or the Children’s Health Insurance Program (CHIP), leaving incarceration, etc.

    See the full list of life events.

    How do I apply for 2020 coverage through a Special Enrollment Period?

    • If you qualify for a Special Enrollment Period, create an account or log into an existing one to enroll in a plan for 2020.
    • You may be asked to submit documents to confirm the life event that makes you eligible.

    Not sure your life event counts as a Special Enrollment Period? Just answer a few quick questions to find out.

  • 3 routine ways to use your 2020 Marketplace coverage

    Health coverage pays for provider services, prescriptions, hospital care, and special equipment when you're sick. It's also important when you're not sick. Now that you're enrolled in a health plan for 2020, here's how you can use your new coverage throughout the year no matter your situation.

    Woman holding sign that reads "Tips"

    Understanding & using your new coverage

    • Preventive health: Most coverage includes immunizations for children and adults, annual visits for women and seniors, obesity screening and counseling for people of all ages, and more for free.
    • Prescriptions: Health plans will help pay the cost of certain prescriptions. You may be able to buy other medications, but those on your plan's "formulary" (approved list) usually will be less expensive. To find out which prescriptions are covered through your new Marketplace plan, visit your insurer's website, call them directly, or check your Summary of Benefits and Coverage.
    • Regular & emergency care: Most health plans give you the best deal on services when you see a doctor who has a contract with your health plan. While you may be able to see doctors who don’t contract with your plan, visiting an "in-network" provider usually means you'll have lower out-of-pocket costs. But in an emergency, get care from the closest hospital that can help you.

    Learn more about using your insurance coverage.

  • 2019 tax season is here! Here’s how to prepare

    Attention: 2019 tax filing season has started. Here’s what you can do now to get ready.

    2019 tax forms

    3 steps to get ready for 2019 tax filing:

    1. Look for Form 1095-A.

      • If you or anyone in your household had a 2019 Marketplace plan, you’ll get Form 1095-A, Health Insurance Marketplace Statement in the mail by early February. It comes from the Marketplace, not the IRS.
      • It may also be available online in your HealthCare.gov account.
    2. Check Form 1095-A for accuracy.

      • You’ll use Form 1095-A to "reconcile" your premium tax credit if you used advanced payments of the premium tax credit to lower your monthly premium payment, so it’s important the information on it is correct. If you file with an incorrect version, you may need to file an amended return later.
      • Confirm things like your coverage and household information, monthly enrollment premium, and “second lowest cost Silver Plan” (SLCSP).
      • If you find errors, contact the Marketplace Call Center. We’ll send you an updated copy. Wait to file until you have it.
    3. Use your correct 1095-A to “reconcile.”

      • Now that you have an accurate 1095-A and second lowest cost Silver plan premium, you’re ready to fill out Form 8962, Premium Tax Credit.
      • See this step-by-step guide to reconciling for next steps.

  • Take advantage of free preventive services in 2020

    With Marketplace coverage, you have access to free preventive services, like flu shots, check-ups, and screening tests. Getting these recommended services is an important step toward good health and well-being.

    Image: {Magnifying glass over doctor's order}

    What are preventive services?

    • Preventive services are routine health care procedures, like screenings, check-ups, and counseling to prevent illnesses, disease, and other health problems.
    • Taking advantage of these free services can help detect illness early, when treatment is likely to work best, so talk to your provider about what’s right for you.
    • Note: Preventive services are free only when provided by a doctor or other provider in your plan’s network. (A network is the facilities, providers, and suppliers your health insurer has contracted with to provide health care services. Contact your insurance company to see which providers are “in-network.”)

    Where can I learn more?

  • Now that you’re covered for 2020, don’t forget to pay your premium

    Congratulations on your enrollment in a 2020 Marketplace plan! Now that you’re covered, don’t forget to pay your monthly premium to your health insurance company (not the Marketplace) to activate your coverage. Your coverage won’t start until you do.

    Image: {Cartooned calculator and money stack}

    {% box %}Important: Continue to pay all monthly premiums on time

    If you don’t, your insurance company could end your coverage.{% endbox %}

    Can I pay my premium online?

    It depends. Each insurance company handles premium payments differently, so follow your plan’s instructions carefully. If you have the option to pay online, follow these steps:

    1. Log into your Marketplace account.
    2. Choose your application under "Your Existing Applications."
    3. Click the blue button "Pay Your First Health Insurance Monthly Premium."
    4. Choose the green button "Pay for Health Plan Now" to go to your insurance company’s website to pay.

    Not sure you’ve paid?

    • Find out if your health insurance is active by checking your online Marketplace account.
    • If you think you're enrolled but have questions about your plan, contact your insurance company. You can also check your plan materials. Your plan should send you a membership package with enrollment materials and a health insurance card.

  • 2020 Open Enrollment is over, but you may have options

    Marketplace Open Enrollment for 2020 coverage ended December 15. If you missed the deadline, you may still be able to get or change 2020 coverage two ways:

    Image: {Woman carrying moving boxes qualifies for Special Enrollment Period}

    With a Special Enrollment Period

    • Since the 2020 Open Enrollment Period is over, you can now enroll in or change a Health Insurance Marketplace plan only if you have a life event that qualifies you for a Special Enrollment Period.
    • A change in your situation, like getting married, having a baby, or losing health coverage, may make you eligible.
    • Answer a few questions to see if you may qualify.

    Through Medicaid or the Children’s Health Insurance Program (CHIP)

    • Medicaid and CHIP provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities.
    • You can apply for either program any time, all year. If you qualify, you can enroll immediately.
    • Select the second button and answer a few questions to see if you may qualify.

    Learn more about your health insurance options outside Open Enrollment.

  • Last chance: The 2020 Open Enrollment deadline is days away!

    Time’s running out for 2020 Marketplace insurance! Open Enrollment for 2020 Marketplace insurance ends Sunday, December 15. This means you have only 3 days to enroll in, re-enroll in, or change a 2020 Marketplace plan.

    Image: {Countdown clock for Open Enrollment deadline}

    Act now for coverage that starts January 1

    • First time applying at HealthCare.gov? Create an account.
    • Have 2019 Marketplace coverage? Log in to update your application and compare plans for 2020. If you don’t, you could miss out on new plans, and any savings could be wrong. This means you could end up paying more for your monthly premium or owing money on your federal taxes.

    Need enrollment help?

  • Time’s running out! Update & compare Marketplace plans by December 15

    If you enrolled in Marketplace health insurance for 2019, you can renew, change, or update your plan for 2020 until Sunday, December 15, 2019. That’s less than 2 weeks away! If you miss the deadline, you may be automatically enrolled for 2020, but that’s not your best option.

    Image: {Smartwatch flashing important reminder to update and compare plans}

    Why update & compare for 2020 — even if you want to keep the same plan

    • New, affordable plans may be available this year. Just like people, plans and prices change every year. You may find 2020 plans with coverage and features that better meet your needs, especially if you’ve had or expect income or household changes.
    • Get the right amount of financial help for 2020. Savings are based on your expected income for 2020 (not 2019). If your information isn’t current, your premium tax credit and other savings could be wrong. This means you could end up paying more for your monthly premium or owing money on your federal taxes.
    • Sometimes you won't be automatically enrolled. You should enroll in an available plan by December 15, 2019 to be on the safe side.

    How to change or renew 2020 coverage

    • Log in to update your application with your expected 2020 income and household information.
    • Compare your current plan with other available 2020 plans. If you want to keep your same plan, you should still update your information and check out all the plans available to you. If you don’t, you could miss out on savings and a plan that better meets your needs.
    • Learn more about changing and renewing coverage for 2020.

  • Why enroll in 2020 Marketplace coverage

    You may think you don't need health insurance, that it's too expensive, or not worth the trouble. While nobody plans to get sick or hurt, bad things happen, even to healthy people. The good news is that enrolling in a 2020 Marketplace health plan may be more affordable and easier than you think. You have until December 15, 2019 to sign up. Coverage starts January 1, 2020.

    Image: {Friends stand together holding signs that read "More affordable and easier"}

    You may be eligible for savings

    Applying can be fast & simple

  • Only one month left to enroll in or change 2020 Marketplace coverage!

    Don’t delay: 2020 Open Enrollment ends December 15, 2019! This means you have just over one month to enroll in or change Marketplace health insurance for coverage starting January 1, 2020.

    Image: {Clock ticking down to the 2020 Open Enrollment deadline}

    Act now & apply

    Enrollment help is available

  • Quickly find your 2020 Marketplace costs

    Open Enrollment for 2020 health insurance is here and ends Sunday, December 15, 2019. Find out in a matter of minutes what your costs may be by answering a few easy questions about you and your household. You don’t even have to log in.

    Image: {Man estimating income calculation on calculator for lower costs tool”}

    Will I save on a 2020 Marketplace plan?

    Find out exact costs & savings when you apply

  • The 2020 Health Insurance Marketplace is open for business!

    Starting today, November 1, you can apply for new 2020 health insurance, or renew, change, or update your 2019 health plan for 2020.

    Image: {Woman applies for 2020 Marketplace insurance online at her laptop”}

    {% box %} Important: You have until Sunday, December 15 to enroll, re-enroll, or change your coverage for 2020. After this date, you can enroll or change only with a Special Enrollment Period. Coverage under plans sold during Open Enrollment starts January 1, 2020. {% endbox %}

    How to apply

    • You can apply at HealthCare.gov or through certified enrollment partner websites, by phone, with the help of a trained assister in your community, through an agent or broker, or with a paper application.
    • See the different ways to apply for 2020 health insurance.

    Not quite ready? See plans & prepare

  • Preview 2020 plans and prices today!

    You can enroll in or renew a 2020 plan November 1 through December 15. You can start by previewing 2020 plans with personalized estimates. Note: You’ll see exact prices later on when you fill out or update your Marketplace application.

    Image: {Woman in track and field starting position”}

    How to preview 2020 plans & prices

    More on 2020 Open Enrollment & plan shopping

  • Things to know about picking a plan before Nov. 1

    Before you apply for 2020 Marketplace health insurance starting November 1, there are several things to consider that’ll help you choose the plan that’s right for you.

    Image: {Man and woman compare health insurance plans on computer"}

    The 4 “metal” categories

    • There are 4 categories of health insurance plans: Bronze, Silver, Gold, and Platinum.
    • These categories show how you and your plan share costs. Plan categories have nothing to do with quality of care.
    • Get more information on Marketplace health insurance categories.

    Health insurance plan & network types

    • Different types of Marketplace health insurance plans are designed to meet different needs. Some plans restrict your provider choices or encourage you to get care from the plan’s network of doctors, hospitals, pharmacies, and other medical service providers. Other plans pay a greater share of costs when you use providers outside the plan’s network.
    • Get familiar with the different plan types you’ll find in the Marketplace.

    Total health care costs

    See tips on choosing an insurance plan.

  • 5 easy ways to prepare for 2020 Open Enrollment

    Open Enrollment for 2020 Marketplace coverage starts November 1, 2019. There are things you can do now to get ready, whether you’re applying for the first time or planning to re-enroll.

    Image: {Checkmark above title text"}

    How to get ready to enroll — quickly and easily!

    • Get familiar with the Marketplace by reading these quick tips. Find answers to your most common questions.
    • Download this checklist (PDF) to make sure you have everything you need. When you apply, you'll be asked about your household, income, and current coverage and may need to refer to specific documents, like W-2s, pay stubs, or tax returns. Gathering what you need now will save you time later.
    • Make a list of questions before it's time to choose your health plan. For example, "Can I stay with my current doctor?" or "Will this plan cover my health costs when I'm traveling?" Get tips on choosing a health insurance plan.
    • Set your budget. There are different types of health plans for different needs and budgets. You’ll need to figure out how much you’re able to spend on premiums each month, and how much you want to pay out-of-pocket for prescriptions or medical services. See how your total costs work together.
    • If you're planning to renew your current coverage for 2020, review your 2019 application to make sure it's still accurate. If it's not, update it with any income and/or household changes. This will save you time when you apply because your 2020 application will be pre-filled with your 2019 information.

  • Less than one month 'til 2020 Marketplace Open Enrollment!

    You have less than one month until you can enroll in a 2020 Marketplace health insurance plan. Here are important dates to remember and some things you can do to get ready.

    Image: {Countdown clock for 2020 Open Enrollment"}

    Key dates & deadlines

    • The 2020 Open Enrollment Period runs November 1–December 15, 2019. This means you have six weeks to enroll in or renew a plan.
    • Plan coverage starts January 1, 2019.

    How to get ready today for November 1

  • Stay ahead of the deadline with 2020 Open Enrollment reminders

    2020 Open Enrollment is almost here! You can apply for or renew your coverage November 1 through December 15, 2019. Sign up for deadline reminders, useful tips, and more so you don’t miss your chance to enroll.

    Image: {Person uses smartphone to connect with HealthCare.gov for important updates"}

    3 ways to stay connected with the Marketplace

    • Get important email or text updates. Visit the HealthCare.gov homepage, and enter your email address under “Get Important News & Updates.” Click “Sign Up.”
    • Connect with someone in your community who can answer your questions. Enter your ZIP code for a list of groups and people near you. Some even offer help in languages other than English.
    • Find us on social media. Follow us on Twitter and like us on Facebook for late-breaking news and important updates.

  • Key 2020 Marketplace enrollment dates & deadlines

    Open Enrollment for 2020 Marketplace coverage is less than 2 months away! Make sure you don’t miss the deadline by adding these important dates to your calendar:

    Image: {Key dates on calendar marked"}

    2020 important dates & deadlines

    • 2020 Open Enrollment starts Friday, November 1, 2019.
    • The last day to sign up for 2020 coverage is Sunday, December 15, 2019.
    • Coverage for people who sign up during Open Enrollment starts January 1, 2020.

    Note: All 2019 Marketplace plans end December 31, 2019, no matter when you enrolled.

    Need coverage for the rest of 2019?

    You may have other options to get or change coverage outside the yearly Open Enrollment Period. Answer these questions to see if you can apply or change through a Special Enrollment Period for the rest of 2019. You can also enroll in Medicaid or the Children's Health Insurance Program (CHIP) anytime. If you're eligible, coverage can begin immediately.

  • 3 benefits Marketplace health plans must cover

    All Marketplace plans cover essential health benefits, pre-existing conditions, and preventive care. This is true for all plan categories (all “metal levels,” including Catastrophic plans) and all plan types (like HMO and PPO). Starting November 1, 2019, you can enroll in or renew a plan for 2020, so you can continue to get these benefits.

    Image: {A doctor explains what Marketplace plans cover to patient"}

    What are essential health benefits?

    • Essential health benefits cover doctor’s visits, prescriptions, hospitalizations, pregnancy, and more. See the full list.
    • These benefits are covered by all Marketplace plans. Specific services covered in each broad benefit category may vary based on your state’s requirements.

    Is treatment for my pre-existing condition covered?

    • All Marketplace plans must cover treatment for pre-existing medical conditions. This means no insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started.
    • If you’re pregnant when you apply, an insurance plan can’t reject you or charge you more because of your pregnancy.

    Are preventive health services included with Marketplace coverage?

    • Marketplace plans cover a set of preventive services, like shots and screening tests, which are free to you when delivered by a doctor in your plan’s network.
    • There are 3 sets of free preventive services for adults, women, and children. Check out the lists here.

    Note: Health plans can offer other benefits, like vision, dental, or medical management programs for a specific disease or condition. You’ll see exactly what each plan offers when you compare on HealthCare.gov.

  • Can you get health coverage for the rest of 2019?

    Outside the yearly Open Enrollment Period, you can only enroll in or change coverage if you qualify for a Special Enrollment Period for a Marketplace plan, Medicaid, or the Children's Health Insurance Program (CHIP).

    Image: {A couple with new baby in a living room with moving boxes"}

    {% box %} Important: Even if none of the options on this page work for you, you can apply for 2020 Marketplace coverage starting November 1, 2019.{% endbox %}

    Do I qualify for a Special Enrollment Period?

    If you experience certain types of life changes — like losing health coverage, getting married, or having a baby — you may qualify for a Special Enrollment Period to enroll in a Marketplace plan for the rest of 2019.

    If you know you qualify, create an account or log into an existing one to start a Marketplace application. If you’re not sure you qualify, answer a few fast questions to find out.

    Do I qualify for Medicaid or CHIP?

    You can apply for Medicaid and CHIP any time of year.

    To apply, fill out a Marketplace application or apply directly through your state Medicaid agency. Get more information on applying for Medicaid/CHIP.

  • Kick off the school year with health insurance!

    Nobody plans to get sick or hurt, but unexpected things happen even to healthy young people, so it’s important to get health insurance. As a college student, you have several options for coverage:

    Image: {A group of college students enroll in health insurance on their devices”}

    Student health plans & other options

    Even if none of these options work for you, you can apply for 2020 Marketplace coverage starting November 1, 2019. Check back soon for more information.

  • When can I enroll in a 2020 Marketplace plan?

    Here are some important 2020 Open Enrollment dates to mark on your calendar:

    Image: {2020 Open Enrollment dates circled on calendar”}

    Key 2020 Open Enrollment dates

    • The 2020 Open Enrollment Period runs from Friday, November 1, 2019, to Sunday, December 15, 2019.
    • If you don’t act by December 15, you can’t get 2020 coverage unless you qualify for a Special Enrollment Period.
    • Plans sold during Open Enrollment start January 1, 2020.

    Looking for coverage for the rest of 2019? Answer these questions to see if you can apply through a Special Enrollment Period. You can also enroll in Medicaid or CHIP any time, if eligible. Coverage can begin immediately.

  • New baby? See your health insurance options

    If you or anyone in your household had a baby or adopted a child within the past 60 days, you may qualify for a Special Enrollment Period to enroll in or change Marketplace health insurance for the rest of 2019.

    Image: {New parents fold baby clothes"}

    How to apply with a Special Enrollment Period

    • New to HealthCare.gov? Create an account to fill out an application for the first time.
    • Already have Marketplace coverage? Log in to update your existing 2019 application.

    When will coverage start?

    When you enroll in or change plans with a Special Enrollment Period, your new health coverage can start the day your baby is born or adopted, even if you enroll in the plan up to 60 days afterward.

    Note: If you adopted, you may need to submit documents, like adoption letters or records, showing the name of the person who became a dependent and the date they became one.

    See the other ways you may be able to get coverage outside Open Enrollment.

  • Special Enrollment Periods: What you need to know

    You may still be able to enroll in health insurance or change plans for the rest of 2019 if you qualify for a Special Enrollment Period. Here are 3 things you need to know about Special Enrollment Periods:

    Image: {Woman holds tablet that reads "Important information on Special Enrollment Periods"}

    3 tips on getting health coverage outside Open Enrollment

    • Certain life changes make you eligible for a Special Enrollment Period. If you experience life events, like losing health coverage, getting married, or having a baby, you may qualify to enroll or change plans for the rest of 2019. Check out the full list of events, or answer a few quick questions to see if you’re eligible.
    • If you qualify, you have a limited window to act. You usually have up to 60 days after the life event to enroll in a plan. If you don’t act in time, you’ll have to wait until the next Open Enrollment Period to apply for 2020 coverage (unless you qualify for another Special Enrollment Period).
    • When you apply for Marketplace coverage through a Special Enrollment Period, you may be asked to provide documents to confirm the events that make you eligible. You must upload them before you can start using your coverage. You have 30 days to submit.

    Learn more about getting coverage outside Open Enrollment.

  • Did you recently move to a new state?

    Summer is a popular time for moving. If you recently moved to a new state, you can’t keep a health insurance plan from your old one. To make sure you stay covered, report your move to the Marketplace as soon as possible. This way, you can enroll in a new plan without a break in coverage and avoid paying for coverage you can’t use in your new state.

    Image: {Map of United States}

    How to apply for health coverage in your new state

    • Moving to a new state makes you eligible for a Special Enrollment Period. This means you can enroll in new coverage or change plans even though the annual Open Enrollment Period is over.
    • How you apply depends on whether your new state uses HealthCare.gov or its own website. If your new state appears on this list, your state has its own website where you’ll apply.
    • If your state uses HealthCare.gov, follow these instructions to start a new application.

    Note: If you move within the same state but new coverage options and savings aren’t available to you, update your HealthCare.gov profile anyway with your new address. This way, the correct one is on file.

    Learn more about changing health insurance after moving.

  • This summer, put your health & well-being first

    Summer is here! Here’s how you can be more proactive with your health this season:

    Image: {Family of three enjoys summertime by canoeing}

    3 ways to maintain your health this summer

    • Take advantage of the preventive services offered by your Marketplace plan. Preventive services include screenings for things like cancer and depression, shots, and check-ups. Note: These services are free only when delivered by a doctor or other provider in your plan’s network.
    • Talk to your doctor about increasing your activity. Whether it’s going on a jog, taking your dog for a walk, or working in your garden, there are many ways to incorporate activity into your life. See other ways to increase your physical activity.
    • Make time for relaxation and sleep. A good night’s rest has many physical and emotional health benefits, and sleep deprivation can impact your mood and performance. Find out how much sleep you need.

    Get more tips on improving your health.

  • Report household & income changes all year

    Has your family, job, or income changed this year? If you're currently enrolled in a 2019 Marketplace plan and experience household changes, update your application as soon as possible. These changes could impact your health coverage or the savings you’re getting.

    Image: {Young man sits at computer to report a life change online}

    What types of changes to report

    • Changes that affect your family size, like getting married or divorced, or having a baby
    • Changes that affect your household income, like changing jobs
    • Changes to the coverage that’s available to you, like becoming eligible for Medicare or Medicaid, or getting insurance through a job

    Read the full list of life changes.

    How to report life changes

    • Report changes to the Marketplace by updating your 2019 application.
    • Update your application online, by phone, or in person (just not by mail).
    • When you report a life change, you’ll get a new Marketplace eligibility notice. It’ll explain if you’re eligible for a Special Enrollment Period to change plans, get new savings, or enroll in a different kind of coverage.

    Learn more about reporting changes to the Marketplace.

  • Calling all graduates: You likely have health insurance options

    Congratulations, graduates! As you set out on your next life adventure, you may have several options for health coverage.

    Image: {A group of young adults stands behind banner that says “3 ways young adults can get health coverage"}

    3 ways young adults can get health insurance

    • With a Special Enrollment Period: If your student health plan is ending, you’re moving to a new state, or you experience other life changes, you may qualify for a Special Enrollment Period to enroll in Marketplace insurance for the rest of 2019. Answer a few fast questions to find out.

    • Under a parent’s plan: If your parent’s health insurance plan covers dependents, you can usually be added to their plan and stay on it until you turn 26. Learn more about getting on a parent’s plan.

    • Through Medicaid, if you qualify: If you’re working part time, starting a business, or otherwise are not making much money, you may qualify for Medicaid. If eligible, coverage can start right away, any time of year.

    Get more information on health insurance options for young adults.

  • Income or household changes? Update your Marketplace application ASAP

    If you're enrolled in a Marketplace plan and have changes to your income or household, update your application with these changes as soon as possible. Changes like higher or lower income, adding or losing household members, or offers of other health coverage may affect the coverage or savings you’re eligible for.

    Image: {Couple updates their application with information changes on tablet}

    What changes to report

    • Changes to your expected income for the year
    • Changes in health coverage, like someone in your household getting an offer of job-based insurance
    • Changes to your household or family, like a birth, adoption, or moving to a new address
    • Corrections to name, date of birth, or Social Security number
    • Changes in disability or tax-filing status

    Check out the full list.

    How to report changes

    • Update your application online, by phone, or in person — but not by mail. Here’s how.
    • Note: If you move to a different state, you’ll need to start a new Marketplace application. Learn more.

    Get more information on reporting changes to the Marketplace.

  • Using your Marketplace insurance when you’re not sick

    Did you know you can use Marketplace health insurance benefits even when you’re not sick? Here’s how you can take advantage of your health insurance benefits all the time:

    Image: {Family bike riding in beautiful meadow}

    Get free preventive services

    • Most health plans must cover a set of preventive services, including shots, check-ups, and screening tests, at no cost to you.
    • Taking advantage of these services can prevent illnesses, disease, and other health problems, and detect illness at an early stage when treatment is likely to work best.

    Get recommended health screenings

    • Marketplace plans cover chronic disease management and rehabilitative and habilitative services and devices.
    • Schedule any preventive appointments you need in advance. This way, you’ll have them on the calendar, and they won’t slip your mind.

  • 3 questions to ask your doctor

    It’s important to understand what services are covered by your insurance plan and what your costs may be before your doctor’s appointment. Here are some questions to ask:

    Image: {Question and answer speech bubbles}

    Does my health plan cover my current doctor?

    • Call your doctor’s office directly and ask if they accept your coverage. You can also check your health plan’s website and their provider directory.
    • You may also want to ask your plan if you need prior authorization before your visit. Without it, you may be charged for things your health plan would have paid for.

    Does my health plan cover the services I need?

    • All private health insurance plans offered in the Marketplace offer the same set of essential health benefits, including prescription drugs, emergency services, and pregnancy, maternity, and newborn care.
    • Some plans may also offer additional coverage. If you have questions about whether a service is covered, contact your plan.

    What will my costs be?

    • Most health plans give you the best deal on services when you see a doctor who has a contract with your health plan (also called an "in-network" provider). You may be able to see doctors who don’t contract with your plan (called "out-of-network" providers), but you may pay more out of pocket.
    • You can avoid any surprises before your appointment by taking the time now to learn which services in your plan aren’t subject to your health insurance deductible. Some plans charge only a copayment for primary care visits before you meet your deductible; others offer discounts on drugs, including generic drugs.

  • Only a few days left to file 2018 taxes

    Tax day is right around the corner! Don’t miss the April 15, 2019 deadline to file 2018 taxes and report your health coverage. No matter how you got health coverage — whether through the Health Insurance Marketplace, your job, or another source — you must report your 2018 coverage status to the IRS when you file taxes.

    Image: {Tax filing deadline circled on calendar}

    Get step-by-step directions & tax forms for your situation

    You must file a federal tax return for 2018 — even if you usually don't file or your income is below the level requiring you to.

    For instructions and forms for your situation, choose your 2018 health coverage status. Your next steps will depend on how you got health coverage last year.

    Had a Marketplace plan in 2018?

    If you or anyone in your household had Marketplace health insurance in 2018, you’ll use Form 1095-A to “reconcile” your premium tax credit on your 2018 taxes.

    Can't find your 1095-A? Get help finding it.

  • 2 steps to 'reconcile' your premium tax credit on 2018 taxes

    If you had a Marketplace plan and used advance payments of the premium tax credit (APTC) to lower your monthly payment, you’ll have to "reconcile" when you file your 2018 taxes.

    Image: {Tax forms, calculator, calendar graphics}

    Step 1: Check Form 1095-A for accuracy

    Make sure your coverage and household information on your Form 1095-A is correct. If anything is wrong, contact the Marketplace Call Center.

    Also, check your SLCSP by looking at Part III, Column B of your 1095-A, titled “Monthly second lowest-cost Silver Plan (SLCSP) premium.”

    The SLCSP premium is incorrect if:

    • Part III, Column B has a “0” or is blank for any month someone in your household had the Marketplace plan.
    • You had changes in your household that you didn’t report on your Marketplace application — like having a baby, moving, getting married or divorced, or losing a dependent.

    If either situation applies to you, use our tax tool to get your correct SLCSP premium.

    Step 2: “Reconcile” your 2018 taxes

    Now that you've made sure your SLCSP premium is correct and your coverage and household information is accurate, you’re ready to file.

Call Us Today! 800-883-0902