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Welcome to the Health Insurance Marketplace!

Written by Bedsider on November 29th, 2018

Details on health care coverage and the Affordable Care Act marketplaces.

UPDATE: The open enrollment period for getting health insurance for next year is happening now! Find out everything you need to about the Affordable Care Act.

Have you heard? You can learn about health insurance and sign up completely online! You don't have to go anywhere or call anyone, so you can find out about your insurance options AND watch cat videos at the same time. If you haven’t heard about these marketplaces—or if you have questions about what they are and how they work—keep reading.

For people who don’t already have health insurance, or who are looking for a new plan, state-based marketplaces are the place to go to shop for quality, affordable coverage—including guaranteed access to affordable birth control. And it’s easier than you might think to sign up.

So what is the marketplace?

The marketplaces are similar to an online store where you can compare different products and choose the one that fits your budget and your needs. When it comes to a marketplace, the product it offers is health insurance. Each state will offer a marketplace, which will let you look at different health plans, compare them to each other, and see how much they cost. The website HealthCare.gov can direct you to your state’s marketplace, so don’t worry about finding it on your own.

Health Plans

The marketplace offers different levels of coverage to fit your needs and your budget. Plans are classified as Platinum, Gold, Silver, and Bronze based on how much the plan will pay for your health care and what services are covered, but every single plan covers essential health care services, including no-cost birth control.

The plans are guaranteed to meet certain standards.

Plans sold in state health insurance marketplaces are called Qualified Health Plans and they offer quality coverage - in fact, they’re required to! To meet quality requirements and be allowed in the marketplaces, Qualified Health Plans must cover the essential health care services you need to stay healthy, at an affordable cost.

Qualified Health Plans are required to cover essential health care services, including:

  • Birth control

  • Family planning visits

  • Maternity care

  • STI and HIV screenings

  • Cervical cancer screenings

  • Interpersonal violence screenings

In fact, some of these important services must be covered at no additional cost to you! If you buy a Qualified Health Plan, you won’t have a copay for your birth control and you won’t be forced to spend any extra money to see your primary care doctor or your gynecologist. And Qualified Health Plans won’t charge you more because you’re a woman, or exclude you from coverage because you have a pre-existing condition.

The plans are designed to fit your budget.

If your income is below a certain level, you may qualify for financial assistance to help cover the cost of your health insurance. That’s right—the government will help you pay for your coverage! There are two ways the government makes the plans in the marketplace more affordable for eligible people: (1) premium tax credits (a.k.a. subsidies) and (2) cost-sharing reductions. Premium tax credits decrease the amount you pay for your health plan each month. Cost-sharing reductions decrease the amount you have to pay out-of-pocket when you visit the doctor, go to the hospital, or fill your prescription. In short: financial help is finally here. The marketplace will help you find the plan that fits your budget and gives you the coverage you need.

The plans aren't "one size fits all."

When shopping in your marketplace, you’ll have lots of choices when it comes to picking the plan that is right for you. Knowing that when it comes to health coverage, there’s no "one size fits all," the marketplace offers Qualified Health Plans of different shapes and sizes. Every marketplace will offer several levels of health plans: Platinum, Gold, Silver, and Bronze.

The plan with the lowest monthly premium that still meets marketplace quality requirements is a Bronze plan. If you choose a Bronze plan, your monthly payment will be less, but you may pay more out-of-pocket when you visit the doctor or go to the hospital. If you choose a Gold or Platinum plan, your monthly payment will be more, but you’ll pay less out-of-pocket in copays or deductibles for every health care service.

Interested in signing up?

To enroll in a marketplace health plan, your first stop should be HealthCare.gov. HealthCare.gov will help you determine if you’re eligible to sign up for insurance in a state marketplace and direct you to where you need to shop. HealthCare.gov will also help you find out if you’re eligible for financial assistance to help pay for your insurance. Just by entering some basic income information, you can find out if you qualify for premium and cost-sharing assistance. You can count on this website to have the information you need to investigate health plan options and decide which one is right for you.

Well, that covers the basics. Now that you have a better understanding of how the marketplaces work, visit HealthCare.gov to learn more about the health plans that are available to you. You’ll be taking an important first step toward a full, healthy life. And remember—make sure you have health insurance by December 15th, 2018!


The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of HeyDoctor, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.