HealthCare.gov is a website where people who qualify can sign up for an Affordable Care Act (ACA) health insurance plan—aka a health insurance plan that meets ACA standards established by the federal government. This website serves as the platform for ACA’s Health Insurance Marketplace and offers insurance coverage to individuals, families, and small businesses who may otherwise be uninsured and are not eligible for government healthcare programs like Medicare.
Who can enroll in health coverage through the Marketplace?
Anyone who lives in the US, is a US citizen or national, and not incarcerated can enroll in health coverage through the Marketplace. ACA subsidies, however, are determined by the number of people in a household and income. If your employer offers health insurance, you also have the right to decline that health insurance and enroll in an ACA plan instead. You can find out if you’ll save money with an ACA plan based on your income by clicking here.
When can I enroll/signup?
Typically, you can enroll in a health insurance plan or make changes to your existing insurance plan during Open Enrollment. Open Enrollment for ACA plans begins November 1st for 2024 plans. If you enroll by December 15th, your coverage will start January 1st. If you enroll by January 15th, your coverage will start February 1st.
Outside of Open Enrollment, certain “qualifying events” can make you eligible to enroll or make changes to a health insurance plan anytime of the year. Some of these events include:
Getting married or divorced
Having a baby
Loss of health coverage
Moving to a different zip code or county
You can enroll anytime of the year and start coverage immediately for Medicaid or the Children’s Health Insurance Program (CHIP).
What’s required when creating a HealthCare.gov account?
Setting up an account on HealthCare.gov is fairly simple. You’ll be asked for basic information like your name, address, email, and social security number. You’ll then be prompted to create a username and password and will be given some options for additional account security.
How do I use HealthCare.gov?
Here’s a step-by-step guide on how to enroll in an ACA health insurance plan on HealthCare.gov.
Visit the Website: Go to the HealthCare.gov website by typing "www.healthcare.gov" into your web browser's address bar. You can also click here to get started.
Create an Account: If you are a new user, you will need to create an account on the website. You'll be asked to provide some personal information, such as your name, contact information, and Social Security number.
Log In: If you already have an account, log in using your username and password.
Start an Application: Once you're logged in, you can start a new application for health insurance coverage. You'll be asked to provide information about your household, including the number of people in your household, their ages, and their income.
Explore Available Plans: After entering your household information, you can browse and compare health insurance plans available in your area. You can filter the plans based on various criteria like monthly premium cost, coverage level, and provider network.
Determine Eligibility: The website will help determine if you are eligible for programs like Medicaid or the Children's Health Insurance Program (CHIP). If you qualify for these programs, you will be directed to the appropriate application process.
Enroll in a Plan: Once you've selected a health insurance plan that fits your needs and budget, you can start the enrollment process. You'll provide more detailed personal information and confirm your selection.
Review and Confirm: Carefully review the plan details, costs, and coverage options before confirming your enrollment. Make sure the plan you choose covers your healthcare needs.
Submit Documents: In some cases, you may need to submit supporting documents, such as proof of income, to verify your eligibility.
Pay Your Premium: After enrolling in a plan, you will need to pay your monthly premium to activate your coverage. The website will provide information on how to make payments to your selected insurance provider.
Keep Your Information Updated: It's important to keep your account information and application up to date, especially if your circumstances change (e.g., changes in income or household size).
Renew Your Coverage: If you already have a HealthCare.gov plan, you will need to renew your coverage during the annual Open Enrollment period or when you experience a Qualifying Life Event that allows for a Special Enrollment Period.
If you have specific questions or need assistance with the enrollment process, HealthCare.gov offers customer support and live chat options on their website.
BioMatrix Specialty Pharmacy can also help break down barriers to care and cut red tape by:
Conducting a thorough benefits investigation on your behalf
Providing a detailed outline of coverage specific to your therapy, including whether it is covered under the medical or pharmacy benefit and if a prior authorization is required
Outlining financial responsibility for prescribed therapy and referring to appropriate financial assistance programs
Identifying specialty pharmacy service providers available under your plan
Providing support for timely prior-authorization and appeals
Financial Resource Guide
Living with a chronic condition can create additional healthcare costs while also impeding one’s ability to work. Our financial resource guide can help.
DISCLAIMER: THIS IS NOT MEDICAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.
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