Description text goes hereThe Affordable Care Act (ACA) Marketplace is an online exchange where individuals and families can shop for and enroll in health insurance plans that meet ACA requirements for essential health benefits and consumer protections.

U.S. citizens and certain lawfully present immigrants who live in the U.S., are not incarcerated, and do not have access to affordable employer coverage can buy a Marketplace plan.scription text goes here

• Open Enrollment: Typically runs from November 1 – January 15 (dates can vary by state).

• Special Enrollment Period (SEP): You can enroll outside of Open Enrollment if you have a qualifying life event—such as losing other coverage, getting married, having a baby, moving, or changes in household income.n

Events like marriage, divorce, birth or adoption of a child, moving to a new ZIP code, loss of employer coverage, loss of Medicaid/CHIP eligibility, and certain changes in income that affect subsidy eligibility.

Yes. Based on your household income and family size, you may qualify for:

• Premium Tax Credits (to lower your monthly payment)

• Cost-Sharing Reductions (to lower deductibles, copays, and out-of-pocket maximums on Silver plans)

Yes. ACA plans cannot deny you coverage or charge you more based on pre-existing health conditions.

• Bronze: Lower monthly premiums, higher out-of-pocket costs

• Silver: Moderate premiums and cost-sharing (and only Silver plans qualify for Cost-Sharing Reductions)

• Gold/Platinum: Higher premiums, lower out-of-pocket costs

You should report the change to the Marketplace right away. This can adjust your subsidy amount—preventing surprises at tax time.

ACA medical plans typically don’t include adult dental or vision. Pediatric dental is included for children under 19. Adult dental/vision coverage is available separately.

Subsidy eligibility depends on your household income, family size, and ZIP code. The Marketplace uses your expected annual income, not last year’s income, so we’ll help you estimate it accurately to avoid under- or overpaying.

Self-employed individuals can enroll in ACA coverage just like anyone else. Your subsidy is based on your net self-employment income after business deductions.

Loss of employer coverage is a Special Enrollment Period trigger. You’ll have 60 days from the loss of coverage to enroll in a Marketplace plan.

Only if you qualify for a Special Enrollment Period due to a life event (marriage, divorce, new child, relocation, loss of coverage, etc.).

No. Some states run their own exchanges, others use HealthCare.gov. Plan options, carriers, and premiums vary by state and even by county.

Yes, all ACA plans include prescription drug coverage. Formularies (lists of covered medications) vary by plan, so we always check your prescriptions before enrolling.

Your final subsidy is reconciled when you file your taxes. If your income is higher than estimated, you may owe back part of the subsidy. If it’s lower, you may get a refund.

We check your providers before enrollment to confirm they’re in-network. If your doctor isn’t covered under one plan, we’ll show alternatives.

Yes. Mental health and substance use disorder services are essential health benefits under the ACA and must be covered.

Without subsidies, monthly premiums vary widely based on age, location, and metal tier. We’ll compare both subsidy-eligible and private options so you can see the full picture.

If you enroll during Open Enrollment, coverage typically starts January 1. If you qualify for a Special Enrollment Period, coverage often begins the 1st of the month after you enroll.

Yes. Birth, adoption, or placing a child for adoption/foster care qualifies you for a Special Enrollment Period. You can add the child to an existing plan or enroll in a new plan for your household.
Coverage start date: You may choose to have coverage retroactive to the date of birth or adoption, or begin the first of the month following enrollment.
SEP length: 60 days from the event date.

Item descriptionYes. Marriage is a qualifying life event. You and your spouse can enroll in a new plan together or join an existing one.
Coverage start date: The plan begins the first of the month following enrollment.
SEP length: 60 days from your wedding date.

Typically no. If you qualify for Medicaid, you cannot receive ACA subsidies. If you lose Medicaid, you qualify for an SEP.
Coverage start date: The first of the month after you enroll.
SEP length: 60 days from the loss of Medicaid.

No. Once eligible for Medicare Part A, you’re not eligible for ACA subsidies. If you lose Medicare, you may use an SEP to enroll in ACA coverage.
Coverage start date: The first of the month after you enroll.
SEP length: 60 days from the loss of Medicare.

Examples include divorce, moving to a new service area, or losing employer coverage.
Coverage start date: Generally the first of the month following enrollment (except birth/adoption which may be retroactive).
SEP length: Most SEPs last 60 days after the event; some also allow enrollment up to 60 days before the event.