Marketplace health insurance is a service, established under the Affordable Care Act (ACA), that allows individuals, families, and small businesses to shop for and enroll in health insurance plans through organized online, phone, or in-person platforms called health insurance marketplaces or exchanges
. These marketplaces offer a range of government-regulated and standardized health insurance plans from participating insurers, designed to meet ACA requirements. Key features of Marketplace health insurance include:
- Coverage of 10 essential health benefits such as outpatient care, emergency services, hospitalization, maternity care, mental health and substance use disorder services, prescription drugs, rehabilitative services, laboratory services, preventive and wellness services, and pediatric care including dental and vision for children
- Protection for people with pre-existing conditions and no lifetime or annual limits on essential benefits
- Availability of financial assistance like premium tax credits and cost-sharing reductions based on income, helping make coverage more affordable
- Eligibility criteria requiring you to live in the U.S., be a U.S. citizen or lawfully present, and not be incarcerated
- The ability to apply online, by phone, with community help, through agents or brokers, or via paper applications
- State-specific marketplaces run by some states (State-based Marketplaces) or a federally-run marketplace (HealthCare.gov) in others, with each providing consumer assistance and standardized plan information to simplify comparison shopping
In summary, the Health Insurance Marketplace is a government-facilitated platform that helps people find and purchase affordable, comprehensive health insurance plans that comply with ACA standards and provide essential health benefits
