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Now that you’re covered, know how to use your insurance!

Healthcare.gov • February 9, 2024

Get the most out of your Marketplace coverage with answers to some common questions, like how to use your coverage and what’s covered. 

Woman checking a computer with text “Know your Marketplace plan.

How do I use my coverage? 

• Get more information about using your coverage , like getting regular and emergency care and how to improve your health. 
• Learn how to put your health first (PDF, 1820 KB). You’ll find tips on how to find providers and prepare for appointments. 

What’s covered? 

All Marketplace plans cover: 

• 10 essential health benefits , including prescription drugs, emergency services, hospitalization, laboratory services, and mental health and substance use disorder services. 
• Free preventive health services at no cost to you when delivered by a doctor or provider in your plan's network. 
• Treatment for pre-existing conditions.  
• Some prescription drugs. Your plan’s list of covered drugs is called a “formulary.” Find your plan’s formulary by calling Member Services, or review your Summary of Benefits and Coverage. 

How do I find a doctor? 

You’ll usually get the best cost for services when you use “ in-network ” providers. You may be able to use providers who aren’t in your plan’s network, but you may pay more.

Find out if you qualify for a Special Enrollment Period

By Healthcare.gov • March 21, 2024
You may be able to enroll in or change your Marketplace plan outside of Open Enrollment. Life events or changes may open a Special Enrollment Period for you.  Image What kinds of life events?Changes in household, like getting married or having a babyChanges in residence, like moving or going away to schoolLoss of health insurance, like job-based or individual coverageGet a full list of qualifying life events.I experienced a life event. What do I do next?Report your change to the Marketplace by updating your application. You can do this online, by phone, or in person. Not sure if you qualify for a Special Enrollment Period? Answer a few questions and find out your options. We'll also tell you if you may qualify for free or low-cost health coverage through Medicaid or the Children’s Health Insurance Program (CHIP).

File your taxes using Form 1095-A, Health Insurance Marketplace Statement®

By Healthcare.gov • March 7, 2024
The tax filing deadline is April 15, 2024. If anyone in your household had a Marketplace plan in 2023, use Form 1095-A, Health Insurance Marketplace®, to file your federal taxes. You’ll get this form from the Marketplace, not the IRS.  Image It’s important to review your Form 1095-A and reconcile your premium tax credit because it could impact your refund or the amount of taxes you owe.Check your online account for Form 1095-AIf you didn’t get your Form 1095-A in the mail, or you can’t find it, check your Markteplace account.Under "Your Existing Applications," select your 2023 application.Select “Tax Forms” from the menu on the left.Download all 1095-A forms shown on the screen.Check your Form 1095-A to make sure your information is correct. If you can’t find your form or think there’s a mistake, contact the Marketplace Call Center.“Reconcile” using Form 1095-AIf you (or anyone in your household) qualified for or used the premium tax credit to lower your Marketplace plan premium:Use your Form 1095-A to fill out IRS Form 8962 (PDF, 110 KB) to reconcile —  to check if there's any difference between the premium tax credit you used and the amount you actually qualify for on your taxes.Get step-by-step directions on how to reconcile. You’ll include Form 8962 with your federal tax return. 

Health insurance and your taxes

By Healthcare.gov • February 22, 2024
If you had Marketplace coverage at any point in 2023 and got the premium tax credit, here’s what you need to know about filing your federal taxes.  Image Keep your Form 1095-A in a safe place This form has important information about the Marketplace plans your household had in 2023. You should have gotten Form 1095-A in the mail, or check your Marketplace account. If you didn’t get this form, contact the Marketplace Call Center. Check that your Form 1095-A is correct Make sure your household and coverage information, the "second lowest cost Silver Plan" amount, and the monthly premium are correct. If you find a mistake, contact the Marketplace Call Center. "Reconcile" with your Form 1095-A If you qualified for or used the premium tax credit to lower your Marketplace plan premium: Use the information from your Form 1095-A to complete Part II of Form 8962 (PDF, 110 KB). If there’s a difference between the amount of the premium tax credit you used during the year and the amount you actually qualify for, it will impact your refund or the amount of taxes you owe. You’ll include Form 8962 with your federal tax return. Get details on how to reconcile.

It's tax season! Check your mail for Form 1095-A

By Healthcare.gov • January 25, 2024
Did someone in your household have a Marketplace plan in 2023?  When you file your taxes, you’ll need Form 1095-A, Health Insurance Marketplace® Statement. This form comes from the Marketplace, not the IRS. Image  1. Find your form It'll be in your mailbox by early February, or in your Marketplace account now. Get step-by-step instructions to find your Form 1095-A online. 2. Check your formIs it correct? It should include information about any Marketplace plans that members of your household had last year.3. Use your form If it’s accurate, use the information on your 1095-A form to "reconcile" any premium tax credit you or your household qualified for or used. To reconcile, you compare two amounts: the premium tax credit you used in advance during the year; and the amount of tax credit you qualify for based on your final income. Find a problem or mistake? Contact the Marketplace Call Center to get a corrected form. Don't file your federal taxes until you get a corrected version.  

Explore your health care options after Open Enrollment

By Healthcare.gov • January 17, 2024
Marketplace Open Enrollment for health coverage in 2024 ended January 15. If you missed the Open Enrollment window, you might still have options for health coverage for the rest of the year.  Image Your health coverage options You may qualify for a Special Enrollment Period to get coverage or change plans if:Your income falls within a certain rangeYou had a qualifying life event, like losing health coverage, getting married, having or adopting a baby, or movingIf eligible, you can enroll in Marketplace coverage for the rest of the year outside the annual Open Enrollment Period.Find out if you qualifyYou can also apply for health coverage through Medicaid or the Children’s Health Insurance Program (CHIP) any time if you’re eligible.These free or low-cost health programs cover hospital stays, doctor services, prescription drugs, and more for children and qualifying adults.Get more information on these programs.Now that Open Enrollment is over, learn more about coverage options for the rest of the year.  

Going once, going twice...Open Enrollment ends soon!

By Healthcare.gov • January 11, 2024
The clock is ticking for you to get health coverage for 2024. Open Enrollment for Marketplace health plans ends January 16. Coverage starts February 1. Image Act now: Enroll in health coverage that meets your budget & needsNew to HealthCare.gov? Create an account to fill out an application for the first time.Already have an account? Log in to update your application, compare plans, and change or renew for 2024. Even if you were automatically re-enrolled, it's important to:Update any income and household changes. Otherwise, your savings might not be correct.Compare plans. There may be new plans and prices that better meet your needs and budget.Questions? Help is availableGet help applying for Marketplace health insurance.

Don’t miss out – get coverage for this year!

By Healthcare.gov • January 5, 2024
Time is running out – your window to apply for, renew, or change your Marketplace plan for 2024 coverage ends on January 15.  Image Not sure where to start? If you’re new to HealthCare.gov, create an account and check out some helpful tips about the Marketplace. Already have a plan? Whether you want to keep your current plan or are looking for a new one, it’s important to log in and update any income or household changes so you get the right savings. You may also discover new plans that better fit your needs. Don’t miss out – make sure you’re covered today.

To begin your coverage, make sure you pay your monthly premium

By Healthcare.gov • December 21, 2023
To start your new 2024 Marketplace coverage, pay the first premium. This is the amount you pay every month to the health insurance company to keep your coverage. Image How to pay your monthly premium to start your coverageFollow your insurance company’s instructions on how to pay.Pay online. You might be able to pay your first premium through your Marketplace account or through your insurance company.If you can't pay online, your insurance company should tell you how to pay your premium. If they didn't, reach out to them.If you aren’t sure you paid, check your Marketplace account to find out if your coverage is active.Get details on how to pay your premium to complete your enrollment.

Beat the deadline! Open Enrollment ends in 1 month

By Healthcare.gov • December 16, 2023
Act now — don't miss the January 16 deadline to apply for, re-enroll in, or change 2024 health insurance. This holiday season, give yourself the peace of mind that comes with taking care of your health. Image Important deadlines to knowJanuary 16, 2024: Deadline to apply for and enroll in 2024 coverage.February 1, 2024: Coverage starts.Apply & enroll nowNew to HealthCare.gov? Create an account to fill out an application for the first time. Have 2023 Marketplace coverage? Log in to update your application, compare plans, and enroll or renew for 2024.Don't miss your chance!If you miss the deadline, you may have to wait until next year to get coverage. You can only enroll in or change your health plan for 2024 after January 16 if you qualify for a Special Enrollment Period. Get help now if you have questions or need help applying. 

Don’t delay: Sign up by Dec 15 for coverage that starts Jan 1!

By Healthcare.gov • December 7, 2023
Time is running out. The December 15 deadline to apply, re-enroll, or make changes for Marketplace coverage that starts January 1 is approaching fast. Act now to avoid any gaps in coverage.  Image Take charge of your health & apply todayActing now means getting the coverage you need for you and your family that starts January 1. If you’re new to HealthCare.gov: Create an account and complete an application.If you have 2023 Marketplace coverage: Log in to your account to update your application, compare plans, and change or renew your plan for next year.Even if you want to keep your same plan for next year, keep in mind that:Certain income and household changes can impact the savings you qualify for. Review and update your application to make sure you choose the best plan for next year.Your health care needs and budget may have changed since you last applied. There might be other plans available that better fit your needs. Explore all plan options so you make the most informed decision.Don’t let the opportunity for January 1 coverage slip away. Get started with an overview of the Marketplace.
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