The Health Insurance Marketplace is where individuals and families shop for ACA plans and apply for premium tax credits and cost-sharing reductions. It runs through HealthCare.gov or a state-based exchange.
It depends on your state. In states that expanded Medicaid, you qualify on income alone up to 138% of the federal poverty level. In non-expansion states, eligibility is narrower and some low-income adults fall into a coverage gap with no Medicaid or Marketplace subsidies.
Medicaid and CHIP are state-run, federally funded programs giving free or low-cost coverage to lower-income adults, families, children, pregnant women, seniors, and people with disabilities. Eligibility is mainly income-based and varies by state; apply any time of year.
Yes. You can choose a Marketplace health plan that includes dental, or buy a separate stand-alone dental plan, but only if you’re also enrolling in a health plan. Separate dental plans have their own premium, and adult plans may have waiting periods.
Generally no. Under the ACA, an insurer can’t retroactively cancel (rescind) your coverage over an honest mistake on your application. Rescission is allowed only for fraud or intentional misrepresentation, and only with advance notice.
Yes, in almost all cases. Federal law gives you guaranteed renewability: your insurer must renew your coverage at your option. It can refuse only for narrow reasons like nonpayment or fraud, never because you got sick or used a lot of care.
You get a grace period first. With a Marketplace plan and the premium tax credit, it is usually three months (if you have already paid at least one month that year). Miss the full amount by the end and coverage can be canceled back to your first unpaid month.
On the federal Marketplace (HealthCare.gov), Open Enrollment runs November 1 to December 15 starting with plan year 2027; earlier years ran into January. Outside it, you generally need a Special Enrollment Period.
On-exchange plans are bought through the marketplace (HealthCare.gov or a state exchange) and are the only way to get premium tax credits. Off-exchange plans are bought directly from an insurer or broker; they follow the same ACA rules but are not eligible for subsidies.
For HealthCare.gov, open enrollment generally runs November 1 to January 15. Enroll by December 15 for coverage starting January 1. Some state-run marketplaces use different dates, and a qualifying life event can open a special enrollment period any time of year.