Individual Insurance

The Affordable Care Act (ACA) authorizes the creation of the Health Insurance Marketplace (also known as the Marketplace or Exchange). The Marketplace will assist individuals in shopping for, selecting and enrolling in private health insurance plans. All private health insurance plans offered in the Marketplace will offer the same set of Essential Health Benefits.

Eligibility

To be eligible for health coverage through the Marketplace, you:

NOTE: Generally, health insurance coverage in the Marketplace covers health care provided by doctors, hospitals, and medical services within the United States. If you’re living abroad, it’s important to know this before you consider buying Marketplace insurance.

Enrollment & Coverage Dates

The Open Enrollment Period is November 1st through January 15th. Enroll by December 15, 2022 for coverage that begins on January 1, 2023. If you do not elect coverage during Open Enrollment, you may not qualify for coverage in 2023 without a Special Enrollment Period. A Special Enrollment Period is a time outside of the Open Enrollment period during which you and your family have a right to sign up for health coverage. In the Marketplace, you generally qualify for a special enrollment period of 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage. If you don’t have a special enrollment period, you can’t buy insurance through the Marketplace until the next Open Enrollment period. Job-based plans generally allow special enrollment periods of 60 days.

If you are looking for 2022 coverage, you may still be able to enroll if you qualify for a Special Enrollment Period. To find out if you qualify for a Special Enrollment Period, please go to the following website, https://www.healthcare.gov/glossary/special-enrollment-period/, call CMS at 1-800-318-2596, or you may call Vantage’s Member Services department toll-free at (844) 833-7505, Monday – Friday, 8:00 a.m. - 6:00 p.m. for assistance.

Few Helpful Steps

A few helpful steps you can take to help prepare before getting started with the Marketplace:

NOTE: If you purchase a health plan through the Marketplace instead of accepting health coverage offered by your employer, you may lose the employer contribution (if any) to the employer-offered coverage. Also, the employer contribution, as well as your employee contribution to employer-offered coverage, is often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace will be made on an after-tax basis. You may want to consult your tax advisor on the income tax consequences of obtaining coverage through the Marketplace.