Frequently Asked Questions

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By Topic: Health Insurance Marketplace (Exchange)

How do licensed insurance agents and brokers become certified to sell Marketplace plans?
To the extent permitted by states, licensed agents and brokers may assist consumers in applying for qualified health ... (more)

Can I get plan information and an estimate of my Marketplace premium without applying?
... (more)

Who can use the Marketplace?
Most people are eligible for health coverage through the Health Insurance Marketplace. To be eligible for... (more)

How do consumers apply for coverage and enroll in a health plan through the Health Insurance Marketplace?
Consumers can file a marketplace application online, by phone through a toll-free call center, by mail or in per... (more)

What is the difference between the Health Insurance Marketplace and the traditional insurance market?
The marketplaces will improve today’s broken insurance markets for consumers and small businesses.  They achieve... (more)

What is a Certified Application Counselor?
Certified application counselors (CACs) perform many of the same functions as Navigators—including educating consumer... (more)

How can I get a copy of the paper application?
The paper application may be downloaded from the CMS website from this link: ... (more)

What if my state is not expanding Medicaid?
Some states haven’t expanded their Medicaid programs. If you live in one of these states, you may not have as many op... (more)

When is the next Open Enrollment Period for Marketplace plans?
The Open Enrollment period for 2015 coverage is November 15, 2014 to February 15, 2015.... (more)

Are there any exceptions or special circumstances when people can enroll outside of Open Enrollment Period?
Open Enrollment for 2014 coverage is over. But you may still have options to get health coverage. • ... (more)

How do I become a provider for a Marketplace plan?
Insurance plans sold in the Marketplace are private health insurance plans.  If you would like to become an in-n... (more)

Can individuals, not associated with an approved organization, become a Navigator or Certified Application ...
In the Federally Facilitated Marketplace, in order to become a Navigator or a Certified Application Counselor, you mu... (more)

What if I become eligible for Medicare in the middle of the year?
If you have a Marketplace plan, you can keep it until your Medicare coverage starts. Then you can cancel it without p... (more)

How can I get help filling out my Marketplace application?
There are people trained and certified to help you understand your health coverage options and enroll in a plan i... (more)

How can my organization bulk order publications from CMS for use at our outreach and enrollment events?
Organizations can order free educational materials from CMS using our online ordering system.  Go to ... (more)

What is the Health Insurance Marketplace?
The Health Insurance Marketplace helps uninsured people find health coverage. Fill out a Marketplace application and ... (more)

How can I find local in-person assistance to help me apply for a Marketplace plan?
You can apply with the help of an assister who can sit with you and help you fill out an online or paper application.... (more)

What is a Navigator?
Navigators have a vital role in helping consumers prepare applications to establish eligibility and enroll in coverage t... (more)

I am self-employed, should I use the Individual or the SHOP Marketplace? What if I own a small business tha...
If you are self-employed and have no employees other than yourself, use the Individual Marketplace. If you have a sma... (more)

How do I get to the Marketplace?
Use to apply for health coverage, compare plans, and enroll online. For the best online experience, v... (more)

Is my state participating in the Medicaid Expansion?
You can use the “Select your State” drop down menu, available here, (... (more)

If I have Medicare, what do I need to know about the Marketplace?
The Marketplace won’t affect your Medicare choices or benefits. No matter how you get Medicare, whether through Origi... (more)

Can I use a Marketplace plan to supplement my Medicare plan?
No. It’s against the law for someone who knows that you have Medicare to sell or issue you a Marketplace policy. This... (more)

How do I apply for Medicaid and CHIP?
You can apply today by contacting your state Medicaid office. Use the “Select your State” drop down menu, available h... (more)

How can I become a licensed Insurance agent?
Agents and brokers but be licensed by the state in which they live before they can be certified to sell insurance in ... (more)

How can I find a job with a Navigator grantee, a Certified Application Counselor organization?
Navigator grantees and Certified Application Counselor organizations are in charge of their own hiring.  Please ... (more)

What are the rates paid to providers in the Marketplace?
Unlike in Fee-for-Service Medicare, the Federal government does not set the fee schedule for the Marketplace. Insuran... (more)

When can I enroll in Medicaid or CHIP? (Is it true that you can enroll in Medicaid and CHIP any time o...
You can apply for and enroll in Medicaid or CHIP any time of year. There’s no limited enrollment period for either Me... (more)

How can my group become a Certified Application Counselor organization?
If your organization is a community health center or other health care provider, hospital, a non-federal governmental... (more)

Where can I get information about whether or not the Small Business Health Options Program (SHOP) is right ...
If you have questions about the SHOP Marketplace for businesses with 50 or fewer employees, call 1-800-706-7893 (TTY ... (more)

How can my group become a Navigator grantee?
The Navigator grant funding opportunity announcement for the upcoming open enrollment period is now closed. The Navig... (more)

What does a CAC organization do?
As a CAC organization, your staff and volunteers will help people understand, apply, and enroll for health coverage t... (more)