Individual Health Insurance Plan Step-By-Step Guide

5 Things To Know About the Health Insurance Marketplace

1. End Date for 2020 Policy Enrollment

You must complete your application by Sunday, December 15, 2019, for individual health insurance coverage starting January 1, 2020. Apply now.

2. Who is Eligible to Use The Market?

To be eligible to register in Federal Marketplace for health coverage, you must reside in America, be a legal U.S. citizen or national (or be legally present), and not currently incarcerated.

3. Two Kinds of Coverage

Based on income, you might be eligible for an insurance program with tax premium credits or for Medicaid/the Children’s Health Insurance Program (CHIP). See where your income fits to see if you qualify for government help.

4. What Does Each Plan Cover

All plans cover pre-existing conditions, 10 fundamental health benefits, and preventative care services.

5. Plans & Costs

You can preview available individual health insurance programs and estimated costs based on income before logging in.

Things To Know Before You Choose A Medical Insurance Plan

Choosing Health insurance coverage can be challenging. Knowing just a couple of things before you compare programs can make it easier.

• The 4 “metal” categories: There are 4 groups of medical insurance plans: cheapest is Bronze, then Silver, Gold, and finally the most expensive and most benefits is Platinum. These classes show how you and your plan share expenses. Plan categories have nothing to do with the quality of care.
• Your total costs for healthcare: You pay a monthly installment to your insurance provider (a “premium”), even if you don’t take medical services that month. You pay over-budget expenses, including a deductible, when you get care. It’s essential to consider both sorts of prices when shopping for a plan.
• Program and network types — POS, EPO, PPO, and HMO: Some plan types let you use just about any doctor or medical care facility. Others limit your options or cost and you must use providers inside their network to receive cost savings.

Remember that insurance company plans may vary in quality. For the 2020 year, HealthCare.gov is improving the medical insurance plan quality scores (or “star ratings”) plan to all countries.

Renew, Change, Or Update Your Individual Health Insurance Plan For 2020

If you hold a Marketplace individual health insurance in 2019, you can renew, change, or upgrade your plan for 2020 until December 15, 2019.

• Whether you want to renew or change plans, we strongly urge you to log in and update your data by December 15, 2019. This way, your new coverage will start on January 1, 2020.
• If you don’t take any action by December 15, you will likely be automatically re-enrolled for January 1 — however, you must upgrade income and family information on your 2020 application to obtain the ideal amount of savings.

Status Of Your 2020 Insurance

You should have got 2 letters: one from your existing insurance company and one from the Marketplace.

Together they describe:

• Your 2020 coverage status
• Which plan (if any) you will be registered in or matched with if you do not act by December 15
• Any changes in your policy and financial aid
• Instructions if you will need to send the Marketplace any records

In case you did not get your insurance provider letter, contact your insurance provider.  If you did not receive the Marketplace letter, contact the Call Center.

Important: Update & Compare plans for 2020

No matter what plan you need to register, we strongly suggest you update your Marketplace application. Your expected income and family information and compare your current plan to what is available for 2020.

• Newer, different, or cheaper plans may be available this year. Policies and prices vary each year. Your situation may have changed. You may find 2020 plans with features and coverage that meet your needs or expect income or family changes.
• Above all, update your application, so your 2020 monetary aid is accurate. Financial help is based on your own expected income for 2020 (not 2019). Your tax credit and savings could be incorrect for 2020 if you don’t update your adjusted gross income and family information.

If it happens:

• You could stop paying more for your monthly premium than you need to.
• You may choose more advance payments of the premium tax credit than you were eligible for. When you file your taxes, you have to repay some or all the difference when you file your federal taxes.

• You could be automatically registered for 2020 — but we strongly advise you to update your application and test out new insurance programs first. If you don’t enroll or renew a plan by December 15, 2019, you might be automatically registered in the same or a similar plan. This way, you will be covered on January 1, 2020. However, the best way to be sure you have a 2020 policy that fits your current requirements, and with the financial aid you eligible for, is to log in to modify your information and view all the plans available to you for 2020. You should do this even if you would like to keep the plan.
• In some cases, you won’t be automatically registered. Just register for any available plan by December 15, 2019, to ensure you’re covered on January 1, 2020.

Cancel your Health Policy: Any Time

You can cancel your Marketplace coverage at any time. Need to do this if you get other health coverage due to a job change, marriage, divorce, or for another reason.

You can end coverage for:

• Everybody on the application after your policy has started. Your termination can take effect immediately the day you cancel, or you can put the Marketplace coverage end date to a scheduled day — like if you know your new policy will start on the first day of the coming month.
• Only some people on the application. Typically, their coverage will end instantly.

Preview 2020 health insurance plans & prices

Till December 15, 2019, you can apply for and enroll in a 2020 Marketplace health coverage policy. Before you log in or start an application, you can preview 2020 plans, with price estimates according to your income.

Get 2020 Plans & Personalized Price Estimates

• Fill your ZIP code and answer a few short questions about your projected income and family members for 2020.
• You will see medical insurance plans and estimated costs available for you for 2020.

• Premium quotes reveal any savings you qualify for based on the basic 2020 information you entered.
• The real Marketplace application asks for additional information. Once you fill it out, you’ll see prices.

Complete Your Registration & Pay Your First Premium

Insurance Payments are handled differently by companies. Follow the directions from your insurer about how and when to make your premium payment. You may have the option to pay online.

Steps to pay your monthly installment at HealthCare.gov

1. Log in to your Marketplace accounts.
2. Select your application under “Your Existing Applications.”
3. Click on the blue button, “Pay Your First Health Insurance Monthly Premium.”
4. If online payment is available, pick the green button “Pay for Health Plan Now” to proceed to your insurance company’s site to cover.

Note: If your medical insurance company does not accept online payment, then they need to have contacted you with the next steps. Contact them in case you haven’t got details on how to pay or aren’t assured that you paid. For their telephone number, check out your plan brochure or visit their site.

How To Determine If Your Health Insurance Is Active

If you’re not sure you are enrolled, you will find out if your health insurance is active by checking your Marketplace account. You can reference your plan stuff if you feel you are registered but have questions about your program.

How to confirm your enrollment online

1. Log in to your HealthCare.gov account.
2. Select your finished application under “Your Existing Applications.”
3. Click on “My Plans & Programs” to determine which program (s) you are enrolled in. Your policy start date depends upon when you registered or changed plans.
4. If you are not sure you finish registration or still do not see your summary, call your insurance company. They could confirm if you enrolled and paid your first premium.

If you’re still facing problems, contact the Marketplace Call Center.

Access Your Plan Enrollment Information

• Your policy will send you a membership package with registration materials and a medical insurance card as evidence of your insurance. You will use the card once you get healthcare services, so keep it in a secure location.
• Carefully examine these and look over your plan’s provider record to understand where you can get care.
• If you did not get a card, call your insurance company to determine whether you have to have received one and to ensure that your coverage is effective. You can find the phone number of your insurer on their website.

Changing Plans After You Are Enrolled

If you registered in an individual health insurance plan for 2020 and wish to change it, in addition, you can do this any time before December 15. Your new policy will take effect on January 1, 2020.

Change Your 2020 program by December 15

1. Log in, go to your 2020 application, and select “My Plans & Programs.”
2. Click “Change Plans” to view other available individual health insurance policies.
3. Click “Change Health Plan” to choose a new plan. Complete all steps to finish your registration.

Terminate Your 2020 Insurance Plan Without Substituting It

• If your individual health insurance plan will be automatically enrolled for 2020: Login, pick your 2019 application, choose “My Plans & Programs,” and then select “Stop Coverage for 2019.” Your policy will be canceled for 2019 and 2020.
• If you will not automatically be registered: Log in and pick your 2020 applications. Select “My Plans & Programs,” & click on the “End/Terminate All Coverage” button.