Enrolling in Marketplace Coverage for 2019

What you need to know for open enrollment season

The open enrollment period for 2019 health insurance coverage through Marketplaces and other individual plans is here. The National Association of Insurance Commissioners (NAIC) has what you need to know to enroll.

Consumers in most states use the federal Marketplace through Healthcare.gov, and for them open enrollment runs Nov. 1– Dec. 15. A few states start open enrollment earlier or end it later. For instance, California is the only state with a start date of Oct. 15. New York ends open enrollment on Jan. 31, 2019. Consumers in California, Colorado, the District of Columbia, Massachusetts, Minnesota, New York and Rhode Island should check with their state Marketplace to confirm dates.

Those who currently have Marketplace coverage or need it in 2019 should take the time to shop for plans. If you already have coverage through a Marketplace plan, review your information to make sure it is accurate. You can update your application with any income and/or household changes. You might qualify for a different amount of help with costs or find a different plan that costs less or better meets your needs.

Learn more about the basics of health insurance and what you need to know to enroll through the marketplace.

What to Look for

If your plan is no longer available in 2019, you should receive a notice from your insurer and from the Marketplace. Even if your plan is continuing, it pays to shop and check whether the doctors or hospitals your family uses are in the plan networks.

If you're looking for a new plan, there are four categories of health insurance plans to choose from on the Marketplace (Bronze, Silver, Gold and Platinum). They're broken up by how costs are shared between you and your insurer. A fifth category, Catastrophic, is available for consumers under 30 years of age or who face a hardship in accessing the other plans. Learn more about the different plans and network types.

What's New for 2019

There will not be a penalty for not having minimum essential coverage. Before, consumers would pay a penalty if they were not enrolled in a health plan. Starting Jan. 1, 2019, that tax penalty will be reduced to nothing. If you don't have major medical health insurance for the 2019 coverage year, you'll be on your own for major health care costs, but you won't be penalized at tax time.

Short-term, limited duration options may offer lower premiums, but they won't cover as much. Short-term, limited duration insurance is not available through the Marketplaces, but you may see it offered elsewhere. It allows for coverage to fill temporary coverage gaps. While they're typically cheaper than the Marketplace and other individual market health plans, there are usually limited benefits, broader exclusions and higher levels of consumer cost-sharing. Before signing up for a short-term plan, it's important to think through what health care services you and your family may need and check whether those services are covered.

There will be more direct enrollment options. This means you might sign up for a Marketplace plan even without visiting HealthCare.gov. You might use an insurer's website or a third-party website. These sites might offer you other types of coverage too, so look closely to know what you're buying. Remember, you can always use HealthCare.gov or your state's Marketplace if you want to be sure to get the protections of the Marketplace plans.

More Information

If you have questions about the health insurance marketplace in your state, contact your state insurance department. For more information on NAIC activity on health care reform, visit the Health Care Reform Special Section.

October 2018

About the NAIC

As part of our state-based system of insurance regulation in the United States, the National Association of Insurance Commissioners (NAIC) provides expertise, data, and analysis for insurance commissioners to effectively regulate the industry and protect consumers. The U.S. standard-setting organization is governed by the chief insurance regulators from the 50 states, the District of Columbia and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer reviews, and coordinate regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally. For more information, visit www.naic.org.

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