Affordable Care Act: Marketplace shopping, what you’ll need

What do I need to know before buying health insurance?  I’ll be buying my own plan, as soon as that website starts working.

Shopper Prepper

Dear Shopper Prepper,

First, keep in mind that the marketplace is only for people who do not have an employer plan offered to them AND who earn less than 400% of Federal Poverty.  If you earn more than 400% (see chart), then you will buy your plan off of the exchange.  To do this, you might want to find a health insurance agent.

Assuming that you are a marketplace shopper, go to healthcare.gov and find out whether your state is running its own website.  You will be able to do this on the home page of healthcare.gov, so don’t worry about whether the rest of the site is working.  If your state has its own website, you will be able to link to it right from there.  Several state websites are operational.  If not, then your best bet is to have patience while the federal website gets fixed.

No matter whether you go to a state or federal marketplace, you will need the same things to get ready:

  • Your Social Security Number
  • Your income for every member of your household who needs insurance
  • Policy numbers for any current health coverage (including Medicaid)
  • A completed “Employer Coverage Tool” if you have an employer

There is a Marketplace Application Checklist, which includes the form for your employer.

You can also check out the insurers who are offering plans in your state.  These insurers will have their own (operational) websites that will give you information about their plans, and may also help you estimate your subsidy.  This will help you get ready, so when the federal site is working all you will have to do is put in your data.

You can get help in-person from your local navigators.  From healthcare.gov’s home page, click the icon that looks like people.  You can then enter your zip code and get a directory of local resources.  You can also ask your doctor’s office or local hospital; many hospitals have health reform enrollment support available onsite.

Recommend this article
Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.