Marketplace Insurance

The marketplace is a government system for purchasing qualifying health plans from private companies such as Blue Cross Blue Shield, United Healthcare, Molina, Oscar, Bright Healthcare, Ambetter, Kaiser, Cigna, Aetna, and many others.

There are two types of enrollment. You can enroll during the normal annual open enrollment period (OEP) from November 1st to December 15th for a plan that starts on January 1st. You can also enroll throughout the year during a special enrollment period (SEP) if you qualify. If you have recently lost other coverage, gotten married or divorced, given birth or adopted, or had a change in immigration status; you might qualify for a special enrollment that gives you your own 60 day window to signup.

Yes. Obamacare is a slang term for the Affordable Care Act (ACA). The ACA is still law and is the primary option for individuals and families to get health insurance outside of employer group benefits.

No. There is no income cap to purchase a marketplace health insurance policy. If your income falls within certain ranges, you might qualify for a reduced monthly price (tax credit)

A premium tax credit is intended to reduce the cost of a health insurance policy for those that qualify based on income. They are technically called an Advance Payment Tax Credit (APTC) since you can take advantage of the savings each month instead of waiting until you file taxes.

On-exchange is referring to purchasing a policy through the marketplace. Off-exchange is referring to purchasing a policy outside of the marketplace. There are many different types of policies that are off-exchange, so be careful. However, some carriers do allow you to purchase the same ACA-compliant policy both on- and off-exchange. If the plan is the same, then there is no difference in whether it’s purchased on- or off-change.

Yes and No. There is still technically a federal mandate requiring people to have a qualifying health plan, however; under the Trump Administration, the monetary penalty for not having a plan was reduced to $0. Certain States have enacted their own laws requiring residents to have certain health insurance policies or face a penalty.

Pros: cover pre-existing conditions, provide coverages for pregnancy, mental health, and prescription drugs, possible lower price based on income.

Cons: full price is expensive, smaller regional network of doctors, complicated pricing and coverage structure on some plans, barely any PPO plans available.

Trumpcare is a term that was created by marketing companies to advertise health insurance policies during the Trump Administration. It was based on the idea that President Donald Trump changed the Affordable Care Act (Obamacare). There were only some minor changes made to the ACA law during the Trump Administration which helped increase consumer options for health plans.

Bidencare is a slang term that has been created by marketing companies to promote health insurance policies during the Biden Administration. There have been no major changes to the ACA law under President Biden except for increasing the tax dollars allocated to the law and expansion of the income range eligibility of tax credits for the 2022 coverage year.