Enrollment Tips

Guide to Buying Health Insurance

Open enrollment begins November 1 and ends December 15

You can only join a health care plan during an enrollment period.

• If you sign up during open enrollment, your coverage will begin on January 1 the following year.
• After December 15, the only time you can enroll in health insurance is if you qualify for a special enrollment period.

If you do not have Health Insurance through another source

Most people receive health insurance from their employer, Medicare, Medicaid, CHIP (Children's Health Insurance Program), or other qualifying health coverage. If you do not, you may be eligible for health insurance through the Health Insurance Market.

Note: Qualifying health coverage refers to any health insurance that satisfies requirements for the Affordable Care Act.

If you have access to health insurance through your job but do not opt-in to the plan, you can get an individual policy. But you will pay the full price for private health insurance you buy yourself.  However, if your employer's insurance fails to meet specific standards, you might qualify for income-based pricing.

If you are a Medicare recipient, Medicare does not permit switching to a private insurance plan. Nor does Medicare permit supplementing your Medicare with a Health Insurance Market plan. They do not allow you to enroll in a Market dental plan.

Your income determines your costs for health insurance

Low-income families may qualify for Medicaid or the Children's Health Insurance Program (CHIP). Children can qualify for CHIP even if their parents do not qualify for Medicaid.

You may qualify for a premium tax credit if your income is between 100% and 400% of the federal poverty level. The tax credit reduces your health insurance premium and out-of-pocket costs like deductibles and copayments. You may use all, some, or none of your tax credit to lower your monthly premium.

However, if you use more tax credit than you qualify for, you must repay the difference on your tax return. On the other hand, if you use less tax credit, you receive the difference as a refundable tax credit when filing taxes.

You buy health insurance anywhere, but the premium tax credit is only available through the Federal Health Insurance Marketplace.

You can apply for Health Insurance in several different ways

The most common way to apply for health insurance is online or over the phone.

Licensed health insurance agents, brokers, and certified enrollment partner websites can also help you enroll in a policy. If necessary, someone in your community can help you or fill out a paper application.

Information needed when enrolling in Health Insurance

When you enroll in a health insurance plan, you will be asked several personal questions about your financial and living situation. This information helps determine which plans for which you qualify.

• Contact info
• Household info – children, dependents, spouse or partner, parents of children, including yourself
• Permanent address – determines eligibility and plans in your area
• People applying for coverage – additional info if your plan will cover more than yourself
• Social Security number – required for each applicant
• Insurance agent or broker info – they will supply this info for you
• Employer and income – provide all sources of income like W-2s, 1099s, investment income, alimony, unemployment, tips, social security, retirement income, any other source of income
• An estimate of your household income
• Any other coverage from Medicare, Medicaid, Tricare, the VA, CHIP (Children's Health Insurance Program), peace corps, or your employer
• Employer health insurance info

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