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We offer ACA Marketplace health insurance for individuals and families. Compare available plans from multiple insurance companies, check whether you may qualify for financial assistance, and get help choosing coverage that fits your healthcare needs and budget.
ACA Marketplace coverage is generally available to people who live in the United States, are U.S. citizens, U.S. nationals, or lawfully present immigrants, and are not incarcerated. It may be a good option for individuals and families who do not have health insurance through an employer, are self-employed, recently lost coverage, turned 26, moved, married, had a child, or experienced another qualifying life event.
Marketplace eligibility and eligibility for financial assistance are separate — not every eligible applicant receives a subsidy. Medicare beneficiaries generally cannot enroll in Marketplace coverage.
Coverage options for adults, spouses, and children who need individual health insurance.
Marketplace coverage for freelancers, contractors, sole proprietors, and small business owners who need their own insurance.
Marketplace plans may be an option when employer coverage is unavailable or does not meet applicable affordability requirements.
A Special Enrollment Period may be available after certain events, including losing coverage, moving, marriage, divorce, birth, adoption, or turning 26.
ACA-compliant plans provide comprehensive health insurance protections that many short-term and limited-benefit products do not provide. Marketplace plans must meet federal coverage standards while giving consumers access to available carriers, provider networks, premiums, and cost-sharing options.
Marketplace plans cover essential services such as doctor visits, hospitalization, emergency care, prescription drugs, laboratory services, mental health care, maternity care, and other required benefits.
Marketplace plans cover the ten essential health-benefit categories. Exact services and cost sharing may vary by plan.
Many recommended in-network preventive services, including certain screenings, vaccinations, and checkups, are covered without a copayment or coinsurance, even before the deductible is met.
Coverage depends on the applicable recommendations, service, provider, and network status.
ACA plans include an annual limit on what members pay for covered in-network services. After reaching that limit, the plan pays the full cost of additional covered in-network benefits for the remainder of the plan year.
ACA Marketplace plans are subject to annual out-of-pocket maximums set by federal guidelines.
Marketplace plans cannot deny coverage, charge a higher premium, or exclude covered treatment because of a pre-existing medical condition.
Marketplace plans must cover treatment for pre-existing conditions.
Depending on household income, family size, location, and access to other coverage, applicants may qualify for premium tax credits that reduce their monthly insurance cost. Some applicants who select a Silver plan may also qualify for lower deductibles, copayments, and coinsurance.
Eligibility rules apply and can change from year to year — we'll help you check.
Compare available plans and insurance companies in your area, including differences in premiums, deductibles, prescriptions, provider networks, and plan structure.
Carrier and plan availability depends on your ZIP code and county.
Provider access, referral requirements, out-of-network coverage, and cost can vary by plan. Comparing the network structure is just as important as comparing the monthly premium.
Health Maintenance Organization
Preferred Provider Organization
Plan networks and referral requirements vary by insurance company and plan. Review the provider directory and Summary of Benefits and Coverage before enrolling.
Depending on the insurance companies available in your area, you may also see other network structures and plan categories.
EPO (Exclusive Provider Organization): Generally requires members to use the plan's network except for emergency care, but it may not require referrals for specialist visits.
Marketplace metal categories describe how costs are generally divided between the member and the insurance company. They do not indicate the quality of medical care. All Marketplace metal categories cover the same essential health-benefit categories, although premiums, deductibles, provider networks, and cost sharing differ.
Usually lower monthly premiums with higher costs when care is used.
Moderate premiums and cost sharing; required for applicants using cost-sharing reductions.
Usually higher monthly premiums with lower costs when care is used.
Exact covered services, networks, deductibles, copayments, and limitations vary by plan.
Outpatient Care
Emergency Services
Hospitalization
Pregnancy, Maternity & Newborn Care
Mental Health & Substance Use Services
Prescription DrugsRehabilitative & Habilitative Services
Laboratory ServicesPreventive & Wellness Services
Pediatric ServicesLicensed Health Insurance Agent
ACA Marketplace ExperienceHelp Understanding Financial AssistancePlan Comparisons Made SimpleEnrollment AssistanceOngoing Support Throughout the YearDepending on your household income, family size, location, and access to other health coverage, you may qualify for a premium tax credit that lowers your monthly premium. Some eligible applicants may also receive lower deductibles, copayments, and coinsurance through a Silver plan.
You can enroll during the annual Open Enrollment Period. Outside Open Enrollment, you may qualify for a Special Enrollment Period after certain life events or coverage changes.
Common qualifying events include losing eligible health coverage, moving, getting married, having or adopting a child, or experiencing certain other household or eligibility changes. The exact requirements depend on the event.
Yes. Self-employed individuals can apply for Marketplace coverage. Eligibility for savings is generally based on estimated household income, including expected net self-employment income.
You can apply, but an offer of employer coverage may affect whether you qualify for Marketplace financial assistance. Eligibility depends on whether the employer plan meets applicable affordability and coverage standards.
Yes. Marketplace plans cannot deny coverage or exclude treatment because of a pre-existing condition.
Marketplace plans include prescription-drug coverage, but formularies, copayments, deductibles, and covered medications differ by plan. We can help you check your prescriptions before enrollment.
It depends on the plan's provider network. We can help you check whether your doctors, specialists, hospitals, and other providers participate before you enroll.
An HMO generally limits non-emergency coverage to its provider network and may require referrals. A PPO usually provides more provider flexibility and may cover out-of-network care, but it can cost more. Exact rules vary by plan.
Insurance-company and plan availability depends on your ZIP code and county. Use the comparison tool or contact us to review the plans available in your area.
No. There is no additional charge for our assistance with comparing plans, checking potential savings, or completing enrollment.
You will generally need household information, dates of birth, Social Security numbers or eligible immigration documents when applicable, estimated household income, and information about any current or available health coverage.
Choose the option that's most convenient for you.
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