Marketplace Open Enrollment
Open enrollment for 2023 health insurance coverage through the Marketplace started November 1 and ends January 15, 2023. If you enroll in a health insurance plan before December 15, 2022, your coverage will start January 1, 2023.
If you don't have health insurance through your job, Medicare, Medicaid, the Veterans Administration (VA), or another source, the Marketplace can help you get coverage. Marketplace health insurance plans provide coverage for benefits like doctor visits, inpatient and outpatient hospital care, prescriptions, mental health services, and laboratory tests. Marketplace plans are also required to provide coverage for pre-existing medical conditions. That means that a plan cannot reject you, charge you more, or refuse to pay for care for any condition you had before your coverage started.
What you pay for Marketplace insurance depends on your expected income for the year. You may qualify for a premium tax credit that lowers your monthly insurance bill. In addition, some people are eligible for extra savings on out-of-pocket costs like deductibles and copayments.
Please note that Marketplace plans are not for people who have job-based health insurance, Medicare, Medicaid, or VA coverage. If you already have this type of coverage or are eligible for it, you will most likely not be eligible for premium tax credits. In addition, if you have Medicare, it is illegal for an insurance company to sell you a Marketplace plan. Medicare and the Marketplace are two completely different programs.
There are several ways to apply for Marketplace coverage. You can apply in any of the following ways:
Online at www.healthcare.gov
By phone at 1-800-318-2596
With in-person help from local enrollment assisters or insurance agents or brokers (you can search for local help here: https://localhelp.healthcare.gov/#/)
With a paper application, available at: https://marketplace.cms.gov/applications-and-forms/marketplace-application-for-family.pdf.
In order to apply, you will need to provide information about your household size, income, and any current health insurance coverage. Even if you currently have a Marketplace plan, it’s a good idea to review your application information to make sure it is up-to-date. In addition, you should make sure that your plan is still the best fit for you.
If you do not sign up for a 2023 Marketplace plan by January 15, 2023, and you do not have another type of health insurance coverage, it may be very difficult for you to find health insurance if you need it later. Outside of Open Enrollment, you can only enroll in a Marketplace plan if you have a special enrollment period. Examples of events that might give you a special enrollment period include getting married, losing your health insurance, or moving to a new county or zip code.
Reprinted with permission from Greater Wisconsin Agency on Aging Legal Services Team