The website features two separate marketplaces to purchase insurance plans. The first, widely-publicized, marketplace is the “Health Insurance Marketplace” for individuals and families. The second marketplace is the Small Business Health Options Program, or SHOP Marketplace, available for small business employers with 50 or fewer employees.
Available Plans
The marketplaces offer several choices for employers and
individuals to choose from. As with all health insurance plans, individuals and
employees will have to pay a monthly premium. Employers may choose to
contribute to these premiums to lower the monthly costs for employees.
Employers that do contribute to premiums may qualify for a tax credit. You will
be able to choose from: Platinum, Gold, Silver, Bronze and Catastrophic health
insurance plans. Coverage will begin as early as January 1, 2014.
The differences in
the plans are the price of monthly premiums, deductibles, and copayments and
the breadth of available doctors to choose from on each plan. All the available healthcare plans must cover
a specified list of preventative services at no cost.
The catastrophic health insurance plan is only available to
individuals under
30 and to some low-income people.
Marketplace catastrophic plans cover 3 annual primary care visits and preventive
services at no cost. After the deductible is met, they cover the same set of essential
health benefits that other Marketplace plans offer.
Health Insurance Marketplace
The Health Insurance Marketplace is the marketplace for
individuals and families to purchase health insurance plans. Individuals and
families may be eligible for lower costs on monthly premiums and out-of-pocket
costs, or get free or low-cost coverage.
Medicare &
Medicaid: Individuals covered by Medicare and Medicaid do not need to
enroll in the Health Insurance Marketplace and the choices and benefits
afforded to these individuals will not change.
Individuals that do not qualify for Medicaid now may qualify for the
program in 2014. In many states the eligibility for coverage is expanding to
cover more individuals.
Questions about Medicare are addressed here: https://www.healthcare.gov/if-i-have-medicare-do-i-need-to-do-anything/
Questions about Medicaid are addressed here: https://www.healthcare.gov/do-i-qualify-for-medicaid/#state=alabama
Health Insurance Marketplace Information:
Questions about Medicare are addressed here: https://www.healthcare.gov/if-i-have-medicare-do-i-need-to-do-anything/
Questions about Medicaid are addressed here: https://www.healthcare.gov/do-i-qualify-for-medicaid/#state=alabama
- At the bottom of the screen you may select your state of residence to learn more about Medicaid expansion in your state.
Health Insurance Marketplace Information:
- Website: https://www.healthcare.gov/families/
- Link to create an online account for the Health Insurance Marketplace: https://www.healthcare.gov/pre-registration.htm
- Health Insurance Marketplace Application Checklist: https://www.healthcare.gov/downloads/MarketplaceApp_Checklist_Generic.pdf
- Information on Qualifying Factors for Lower Costs on Marketplace Coverage: https://www.healthcare.gov/how-can-i-save-money-on-marketplace-coverage/
- Phone number: 1-800-318-2596 (TTY users: 1-855-889-4325). Available 24 hours a day, 7 days a week
SHOP Marketplace (Small Business Health Options Program)
The Small Business Health Options Program (SHOP Marketplace) is designed to help employers with 50 or fewer full-time equivalent employees select a healthcare plan. The website allows employers to fill out a single application to compare price, coverage, and quality of plans in a simple straight forward manner that any layperson can understand. Self-employed individuals will not use the SHOP Marketplace and should instead use the Individual Marketplace.
The SHOP Marketplace also provides information on the small business healthcare tax credit. To qualify for the tax credit the small business must get coverage through the SHOP Marketplace. The maximum tax credit available is a credit for half of the amount of the premium contribution made by the employer.
SHOP Marketplace Information:
- Link to create an online account for the SHOP Marketplace: https://www.healthcare.gov/marketplace/global/en_US/registration#signUpStepOne
- Phone number: 1-800-706-7893 (TTY users: 1-800-706-7915).Hours: Monday through Friday, 9 a.m. to 5 p.m. EST
- Small Business Healthcare Tax Credit: Determine if you qualify: https://www.healthcare.gov/will-i-qualify-for-small-business-health-care-tax-credits/
Helpful Links
- 1-page guide to Health Insurance Marketplace for Individuals: https://www.healthcare.gov/get-covered-a-1-page-guide-to-the-health-insurance-marketplace/
- Types of Health Insurance: https://www.healthcare.gov/what-are-the-different-types-of-health-insurance/
- Preventative Services Covered by All Marketplace Health Insurance Programs: https://www.healthcare.gov/what-are-my-preventive-care-benefits/
- Essential Health Benefits Covered by Marketplace Health Insurance Programs: https://www.healthcare.gov/glossary/essential-health-benefits/
- 5 Things to Remember when Shopping on the Health Insurance Marketplaces, Kaiser Health News: http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/100413-Michelle-Andrews-5-things-to-remember-when-shopping-for-marketplace-insurance.aspx
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