What Exactly is This Marketplace and Why Should I Care?

The Affordable Care Act (ACA) says most individuals must have health insurance as of 2014. So the law required that health insurance exchanges — or “marketplaces” — be established in every state as a way for individuals to buy private health insurance on their own. 

Most people get insurance through their jobs. But if you don’t have that option, you can shop in the marketplace instead of buying directly from an insurance company. Or maybe you have a certain health problem that in the past prevented you from getting health insurance because it was too expensive or simply hard to get. Now you will have options in the marketplace. 

All individual and small-group health plans must provide a minimum package of “essential health benefits,” which include a basic set of services like physician visits, hospital and emergency care, preventive services like vaccines and screenings, and prescription drugs. So any health plan you purchase in or even outside the exchange must cover these services, and the insurance company cannot deny you coverage because of a pre-existing condition. 

Instead of having to search out health plans on your own, the marketplace is designed to be a one-stop-shop where you can go online to check out your coverage options, get easy-to-understand information, and compare plans before you make a decision — kind of like Orbitz or Travelocity, but for health insurance instead of travel. You also can find out right then and there if you can get a tax break on your private insurance premiums or if you qualify for state programs like Medicaid or the Children’s Health Insurance Program (CHIP).  

The time to sign up for plans offered in the marketplace is approaching fast: Open enrollment is begins Nov. 15 for coverage beginning Jan. 1, 2015. Unless you qualify for an exemption under the federal law, you must get insurance or you could have to pay a fine.

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Last Updated On

October 22, 2014

Originally Published On

September 12, 2013