Top Questions

  • You may have been turned down by a health plan, received limited coverage or were asked to pay more. Unless they were part of a group, many people who have a pre-existing health issue have not been able to get an affordable health benefit plan. That changed under the Affordable Care Act. If you have a health issue before you apply for insurance—it will not stop you from getting coverage.
  • Parents can keep adult children on their insurance plan. Most limits to keeping your young adult children, up to 26 years old, on your coverage have been removed, meaning they don’t have to be a full-time student, live with you, disabled or a tax dependent.
  • Preventive screenings and services are now covered. It can be challenging to maintain your health without continuous care. Each new health insurance plan will cover preventive services at no added cost to you when you use a network provider.
    • You can expect to see things like yearly wellness exams, recommended vaccines for children and adults, mammograms, blood pressure screenings, osteoporosis screenings, type 2 diabetes screenings for adults with high blood pressure, adult obesity and tobacco use screenings.
  • Your insurance cannot be canceled because of your health status. You will not be dropped from your insurance just because you are sick.
  • There are no dollar limits on the care you receive for essential health. Your coverage cannot have a dollar limit on essential health benefits while you’re enrolled in that plan.

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You can go online at or call 1-800-318-2596 to learn about health insurance plans available in your area. Plans on the Marketplace will offer comprehensive health coverage, from doctors to medications to hospital visits.

You can compare all your health insurance options based on price, benefits and other features that may be important to you, in plain language. You can apply for coverage online, over the phone or with a paper application. Open enrollment is November 15, 2014 through February 15, 2015 for coverage starting in 2015.

All plans on the Marketplace will have similar benefits, and all will include a comprehensive package of health benefits. Where they differ is on how the costs of the benefits are applied.

Plans on the Marketplace are divided into four different levels—Bronze, Silver, Gold and Platinum.

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No matter what state you live in, you can visit the Health Insurance Marketplace to shop for and purchase coverage. Some states are creating their own marketplaces while others are using the Marketplace created by the federal government. Click here to find out what your state is doing.

All insurance plans available through the Marketplace will be offered by private insurance companies. Prices are approved by state insurance departments and/or the federal government. When you use the Marketplace to compare plans you’ll see prices for all plans available to you. Prices will show any cost savings you may be eligible for based on your income. These lower costs are available only through the Marketplace.

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Yes, you can even purchase a plan on the Marketplace before COBRA runs out. When you leave a job, you may be able to keep your job-based health coverage for a period, usually up to 18 months. This is called COBRA continuation coverage.

You may change from COBRA coverage to Marketplace health insurance coverage any time. Losing your COBRA coverage qualifies you to buy health insurance on the Marketplace, even if it’s not during open enrollment. At any time during the year you can visit the Marketplace to find your options, compare plans and enroll.

The health plans offered through the Marketplace will have provider “networks.” Networks are the groups of hospitals, doctors, pharmacies and other health professions that the insurance company offering the coverage works with. Your doctor may or may not be included in this network, but your insurance may provide coverage for non-network providers. If keeping your doctor is important to you be sure to check if he or she is on the insurance plan you’re considering buying and if the plan provides coverage for out-of-network providers.

Each new health insurance plan will cover preventive services at no added cost to you when you use a network provider. Here are some of the benefits you can expect in your plan:

  • Yearly wellness exams
  • Recommended vaccines for children and adults (including flu shots)
  • Mammograms, blood pressure and osteoporosis screenings
  • Diabetes (type 2) screening for adults with high blood pressure
  • Adult obesity and tobacco use screenings

Yes, you can get dental coverage two different ways when you sign up for new coverage. You may be able to find plans that include a dental plan while shopping. If your plan includes health and dental you will only have to pay one premium. If you can’t find a health plan you like that also has dental, you can opt for a stand-alone dental plan. This separate plan will require a separate premium payment.

If you have had difficulty affording health insurance, go online or call the Marketplace to determine if you are eligible for a government insurance program, or tax credits and financial assistance to help pay for coverage.

When you shop on the Marketplace, you may qualify for a premium credit that will lower your monthly insurance cost. Depending on your situation, you may even be eligible for a $0 premium plan. You’ll be able to see what your health insurance premium, deductibles and out-of-pocket costs will be before you make a decision to enroll.

You may qualify for lower costs on monthly premiums. It depends on the size of your family and the size of your household income. Typically, people at lower income levels will qualify for higher subsidies. When you apply for health insurance and fill out your application you will be able to see prices that show any savings you qualify for.

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Enrollment for the year of 2014 has closed. Open enrollment for the year of 2015 starts November 15, 2014 and ends February 15, 2015. If you have had a recent life change you may be able to enroll under “special enrollment.” To find out if you qualify for this type of enrollment, click here. If you did not meet the deadline for coverage in 2014, you may be subject to a penalty fee.

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If you did not get insurance coverage for 2014, you may be subject to a penalty on your tax return. This fee is either 1% of your yearly household or $95 per adult, whichever is higher. For children under the age of 18 the fee is $47.50. In 2015 the fee for not having coverage will increase to 2% of income or $325 per person, whichever is higher. You’ll pay the fee on your 2014 federal income tax return. Most people will file this return in 2015.

If you don’t have insurance for just part of the year, you have to pay 1/12 of the yearly penalty applies to each month you’re uninsured. If you don’t have insurance for less than 3 months, you don’t have to make a payment.

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Your Medicare benefits are secure

  • Under the new health care law, your guaranteed Medicare-covered benefits won’t be reduced or taken away.

You can choose your doctor

  • The new law does not change how you select your own doctor. You will continue to choose your doctors based on Medicare guidelines. If you are enrolled in a Medicare Advantage Plan or group health plan, different rules may apply. Check with your plan provider for details.

More preventive services are covered

  • Medicare now covers certain preventive services, with no added out-of-pocket cost for care such as flu shots, mammograms, osteoporosis screening and immunizations.

You can compare nursing facilities and services at home

  • Skilled nursing facilities will publish information about the owners and how they operate to help people compare services.
  • High-needs Medicare patients will have access to basic health care services in their homes. This will help prevent hospital stays and improve their satisfaction.

New health plans will cover screenings and services essential to women with no out-of-pocket costs. Simply visit a doctor in your health plan’s provider network. Here are some of the essential benefits:

  • Mammograms and pap smears
  • Interpersonal and domestic violence counseling
  • Counseling and screening for HIV
  • Immunizations such as the annual flu shot
  • Breastfeeding support, supplies and counseling

Kids now have more options for insurance. Health coverage is available for all kids, even those with medical conditions.

Young adults can now stay on their parent’s health plan up to age 26. Most limits to keeping your young adult son or daughter on your coverage have been removed, meaning they don’t have to be a full-time student, live with you, be disabled or be a tax dependent.

Helpful Materials

We offer helpful materials for you to download and keep in case you need some additional information for the New Health Care Law.

View materials »

Key Dates

November 15, 2014:
2015 open enrollment begins

February 15, 2015:
2015 open enrollment deadline

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