Frequently Asked Questions
Doctor bills can be expensive and you might not always have enough money for the medical care you need when you need it. Insurance is a way to pay a fixed amount of money every month, regardless if you are sick or healthy, in order to cover medical expenses when they occur.
Applying for health insurance has never been easier with Marketplace America. Simply enter 5 pieces of information (zip, household size, household income, age, smoker / non-smoker) to view all of your available plans. After you choose a plan, fill in your personal information to complete the enrollment process in less than 10 minutes. It’s that easy!
In the past, affordable health insurance could be hard to find. Individuals and families relied primarily on their employer to provide coverage. Now, people can obtain new health insurance Marketplace coverage through Marketplace America. Get a free health insurance quote in under 1-minute without entering any personally identifiable information.
The health insurance Marketplace is where you can go to see health insurance plans offered in your area that are eligible for government assistance. Marketplace America is your connection to the health insurance Marketplace.
It’s never been easier or more affordable to get health insurance. Open enrollment begins Nov 15th, 2014 and ends Feb 15th, 2015. Find the best affordable health insurance available for you. All Americans must have insurance or pay a health insurance penalty. The penalty for not having insurance in 2015 is a minimum of $325.00 per adult and will increase each year. Estimate your no-coverage penalty with our Health Insurance Penalty Calculator.
The plans sold on this health insurance website are not government health insurance plans. The plans are issued by name-brand insurance providers like Aetna, Blue Cross Blue Shield, Humana, and many others. The plans are sold through the government health insurance Marketplace and may be paid for by your government subsidy. All of the plans found on Marketplace America accept the government subsidy as payment.
Cost of Health Insurance
The new health insurance Marketplace makes health insurance more affordable. Many individuals qualify for subsidies covering their entire monthly premium payment. You may qualify for low cost insurance or insurance at no cost to you. Learn more about Health Insurance Subsidies.
Well, there is no such thing as free health insurance but some of the plans on the Marketplace can be fully paid for with a government subsidy. Learn more about Health Insurance Subsidies.
Prices of all plans are fixed by law. Plans must be sold at the quoted price of the plan by the insurance provider. At Marketplace America, we guarantee the lowest prices allowed by law with no additional fees.
Some plans require you to pay a small amount when you see your family doctor (also known as your primary care physician). Click on the white “Details” button in the plan you are interested in purchasing. Then, look under the “Medical Cost Sharing” title to see all of your plan copays. Still have questions? Call us toll free at (800) 370-5150.
Some plans require you to pay a small amount when you fill a prescription. Click on the white “Details” button in the plan you are interested in purchasing. Then, look under the “Drug Cost Sharing” title to see all of your plan copayments. Still have questions? Call us toll free at (800) 370-5150.
Health Insurance Coverage
All insurance sold on the Marketplace must cover certain essential health benefits. Plans must include benefits for going to see family doctors, hospitals, prescription drugs, and many more. There are 10 essential health benefits every plan must cover: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services.
Every health insurance plan does not cover every prescription. To view a list of prescriptions covered by the health insurance plan you are interested in purchasing, click on the blue “Drug Coverage” link under the “Coverage” title. Still have questions? Call us toll free at (800) 370-5150.
Every doctor’s office does not accept every insurance plan. To view a list of doctors that accept the plan you are interested in purchasing, click on the blue “Find a Doctor / Hospital” link under the “Coverage” title. Still have questions? Call us toll free at (800) 370-5150.
Understanding Health Insurance Terminology
A health insurance subsidy is the portion of the insurance premiums the government pays for you. Subsidies help make health insurance more affordable, and Marketplace America makes sure you get the largest subsidy allowed by law. Learn more about Health Insurance Subsidies.
A monthly premium is the price of the insurance policy. You are required to pay your premium each month, regardless of whether you are sick or healthy, in order to keep your policy active. With subsidies, you may qualify for an insurance policy that does not require you to make a monthly premium payment.
A copay is your share of the medical expenses even if you have not met your deductible or out of pocket maximum. For example, a visit to your family doctor may only require a copayment of $20 instead of paying the full amount of the bill even if you have not met your deductible.
An annual deductible is the amount you pay for certain health benefits before insurance will pay for your medical claims. For example, if your deductible is $250, you would pay for 100 percent of the first $250 of medical expenses. After your deductible has been met, insurance could pay for 100 percent of the bill or require you to pay coinsurance. Deductibles are met on an annual basis. Once you have met the deductible, you will not be required to pay the deductible again until the following calendar year.
Coinsurance is your share of the medical expenses after the deductible has been met. It is usually a percentage of the total cost. For example, assume you have already met your deductible and your coinsurance is 10 percent. If you receive a medical bill for $100, then you would pay $10 and insurance would pay $90.
The out of pocket maximum is the most you will have to pay in medical expenses in any calendar year. Insurance will pay for 100 percent of all covered medical expenses after you have met your out of pocket maximum. For example, assume you have a health insurance plan with an out of pocket maximum of $1,000. Then, you require a surgery and hospital stay costing $25,000. You would only pay $1,000 and insurance would pay $24,000.
Who Qualifies for Marketplace Insurance
Yes. All the plans on the exchange allow you to obtain care for treating diabetes and you may not be denied health insurance because you are diabetic. Specific medications to treat diabetes may or may not be covered by the plan you select. Click on the “Drug Coverage” link in the plan you are considering to view a list of covered medications.
Yes. Self-employed individuals are eligible for the health insurance plans sold at Marketplace America. Even if you have tried to get health insurance in the past and failed, a health insurance subsidy will make your insurance more affordable. Many self-employed individuals are finding that plans are now more affordable than ever. Find which Health Insurance Plans are available for you.
Yes. People under the age of 30 may buy a catastrophic health plan. Generally, these health plans have a lower monthly premium and a higher deductible.
Marketplace America does not offer short-term medical plans. If other coverage is obtained during the year, Marketplace health insurance plans may be cancelled. There is no penalty for cancelling your plan, but you may be subject to the no-coverage penalty.