Getting Health Insurance through the Insurance Marketplace

By | March 2, 2015

What are the requirements for obtaining insurance from the health care market place. ObamaCare’s Health Insurance Marketplace, or ObamaCare Marketplace, is your State’s price comparison website for subsidized health insurance. No one can be denied coverage on the marketplace for health related reasons. The only factors that can affect premiums of New Insurance Plans starting in 2014 are your income, age, tobacco use, family size, geography and the type of plan you buy. This applies to all plans sold through your State’s health insurance marketplace.


What is the ObamaCare Health Insurance Marketplace?

Marketplaces, sometimes called “Exchanges”, are state- or federally run places where people can buy health care coverage. They include websites, call centers, and physical locations, so you can get coverage online, over the phone, or in person. You can compare and choose health plans offered by private companies, get answers to questions, and find out if you are eligible for financial assistance or special programs.


Marketplaces also operate a Small Business Health Options Program (SHOP)

Marketplaces also operate a Small Business Health Options Program (SHOP). There, small-business employers of 50 or fewer employees can purchase coverage for their employees.
 Employers of 24 or fewer employees may qualify for a tax credit for coverage purchased through the SHOP.

The Marketplace provides new health coverage options for many Americans. If you have family and friends who don’t have health coverage, tell them to visit to learn more about their options.


Qualifying for Health Insurance Marketplace

Most people can get health insurance through the insurance market. To be eligible for medical coverage through the insurance market, you:

  • Must reside in the US – If you are considered a “resident” of the United States for tax purposes, you are eligible to use the insurance market. The territories of the United States can decide whether to create your own Health Insurance Market or expand Medicaid coverage. The residents of a US territory are not eligible to apply for medical coverage using federal or state Markets Insurance, unless also qualify as a resident in the service area of a market. Residents of US territories are not required to have medical coverage under the health care law.
  • Must be a US citizen or national (or be legally present) – A US national is someone who is a citizen or someone who is not a US citizen, but owes permanent allegiance to the United States .. With very limited exception so that the person is entitled to be protected, all non-US citizens nationals are people born in American Samoa or abroad with one or more parents of American Samoa under certain conditions.
  • You can not be jailed

If you have Medicare, you will not be using the market to buy a dental doctor or supplemental insurance plan. Learn more about Medicare and the Market.


US citizens living outside the US

US citizens who are living abroad for at least 330 days of a 12-month period are not required to obtain medical insurance for that period of 12 months. If you are uninsured and living abroad qualifies for an exemption for medical coverage. This means you do not have to pay the penalty as others who have no insurance and must pay.

Check question 12 on the IRS document to learn more about the rules for people living abroad. Usually, the insurance market plans cover care provided by doctors, hospitals and other services in the United States. If you live abroad it is important to know before buying coverage in the insurance market.


Deadline to Enroll in Health Insurance Marketplace

2015 open enrollment in the Health Insurance Marketplace started November 15th, 2014 and ends February 15th, 2015. The February 15th was the last day to enroll in a plan Market or replace it. You can still get get coverage in two ways:

  • If you qualify for a Special Enrollment Period due to a change of life as being married, had a baby or lost other coverage.
  • Through Medicaid and Health Insurance Program for Children, which offer coverage to individuals and family groups in case you have limited income or other reasons.