An individual or family health insurance marketplace (also referred to as a health insurance exchange or health insurance exchange) provides consumers with access to private health insurance plans and income-based subsidies that make coverage and care more affordable (both online and in person).Â
There is only one official health insurance marketplace in each state, operated either by the state or the federal government. The marketplace and customer service center are operated by HealthCare.gov in many states. There are, however, some states with their own platforms, such as Covered California, New York State of Health, Connect for Health Colorado, and Minnesota.
During the implementation of the Affordable Care Act, states abandoned their own enrollment platforms and switched to HealthCare.gov. Recently, that trend has reversed: New Jersey and Pennsylvania operate their own exchanges, and three more states will follow in 2021: Maine, Kentucky, and New MexicoRecently, that trend has reversed: New Jersey and Pennsylvania operate their own exchanges, and three more states will follow in 2021: Maine, Kentucky, and New Mexico.
How Do The Health Insurance Marketplaces Work?
Most Americans are eligible to use the health insurance marketplace, except those with Medicare coverage.
On the other hand, marketplaces were designed to provide coverage to uninsured and already insured individuals and families.Â
In this group are self-employed individuals, small business employees without health benefits, and people who retired before 65 and are therefore not eligible for Medicare coverage.
It is likely that most non-elderly Americans will get their insurance from their employer, so they will not need to use an insurance marketplace. Instead of using their employer’s coverage, they can shop around for a plan in the marketplace, but financial assistance won’t be available unless the employer’s coverage is considered unaffordable and/or does not provide minimum value.
Almost all Americans who are not elderly and are eligible for Medicaid can enroll or determine their eligibility through the marketplace. Depending on the state, the Medicaid enrollment process may be finalized through the marketplace, or it may be handed over to the state Medicaid agency by the marketplace.
