How Do I Sign Up for an ACA Plan Through The Marketplace for 2023?
Since open enrollment for health insurance in 2023 has opened as of November 1, 2022, it is important to understand what steps you need to take to enroll. This article will walk you through the process of gathering information required to apply and the methods.
Signing Up for an ACA Plan Through The Marketplace
The federal Health Insurance Marketplace is the official website to browse and enroll in the available plans under the Affordable Care Act (ACA). The ACA was enacted to make affordable health insurance more accessible. The following takes you through the steps you should take to enroll in a health coverage plan.
When is open enrollment for the marketplace?
Open Enrollment for health coverage for 2023 begins on November 1, 2022, and runs through January 15, 2023. For the remainder of 2022, you may qualify to enroll through the Special Enrollment Period. You may also be eligible to apply for Medicaid or the Children’s Health Insurance Program (CHIP) at any time, based on your income.
Step 1: Gather the Required Information
Gathering the required information when applying for an ACA health plan is a good idea. Below is a list of the information you will be asked to provide when signing up for a health coverage plan:
- Basic personal information such as name and date of birth.
- Information about every person in your household. This includes a spouse, any children, whether dependent or not, etc.
- Home and mailing address.
- Basic information about everyone applying for coverage, including you, your spouse, and your dependent child.
- Social security numbers of yourself and everyone applying for coverage.
- Information about a professional who may be helping you apply.
- Immigration documents for lawfully present immigrants applying.
- Tax filing information- whether you file separate or joint, and your tax dependent claims.
- Employer and income information about everyone in your household, whether or not they are also applying for coverage.
- Best household income estimate.
- Current health coverage information of anyone in your household, if any.
While this is a lot of information, it is essential to have it readily available when enrollment begins, making the application process faster and easier.
Step 2: What to Consider When Browsing Plans
There are certain aspects to consider
- Your budget: It is important to consider your budget because health coverage plans include premiums, deductibles, copays, and coinsurance. Another thing to consider is whether or not you can save on plans, which you can find out using this savings estimate tool.
- Provider preferences: Certain plans limit your choices of providers and may charge you more for having providers out of network, while other plans allow you to choose any provider. The four major types of plans are listed in the table below.
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Types of Health Insurance Plans
| Health Maintenance Organization (HMO) | This plan typically has lower premiums, out-of-pocket costs, and flexibility in choosing providers. You will have to pay completely out-of-pocket for out-of-network providers. |
|---|---|
| Point of Service Plan (POS) | This plan usually has higher premiums because they cover out-of-network providers and have a higher cost for in-network care. |
| Preferred Provider Organization (PPO) | This plan allows you to freely choose physicians out-of-network without referrals. It is a good option if you can afford high premiums and need frequent care. |
| Exclusive Provider Organization (EPO) | This plan is not commonly chosen and only covers in-network services. |
- Method of applying: There are multiple ways to apply for health insurance:
- Apply online through the official federal website Healthcare.gov.
- Apply through a Certified Enrollment Partner.
- Contact the Marketplace Call Center and apply over the phone.
- Mail in a paper application.
- Use local help to get assistance with your application.
Step 3: Picking the Best Plan for Your Needs
There are four health plan categories: bronze, silver, gold, and platinum. These are called metal tiers, and determine how you and the insurance company will split costs. The different metal tiers do not determine the quality of the healthcare you will receive.
Cost Splitting Between Insurance Company and You Based on Metal Tier
Plan | Best Suited For | Insurance Company Covers: | You Cover: |
|---|---|---|---|
Bronze | those who are fit and healthy and want to protect themselves from worst-case medical scenarios | 60% | 40% |
Silver | those who might need a little more medical attention than the average person | 70% | 30% |
Gold | those who will need frequent access to care (e.g., chronic conditions) | 80% | 20% |
Platinum | those who will need frequent access to care and are willing to pay higher premiums in exchange for the majority of medical expenses covered | 90% | 10% |
Source: Mira Health, Healthcare.gov
Average Premium Cost Across the US Based on Metal Tier
State | 2022 Average Lowest-Cost Bronze Premium | 2022 Average Lowest-Cost Silver Premium | 2022 Average Lowest-Cost Gold Premium |
|---|---|---|---|
Alabama | $418 | $569 | $697 |
Alaska | $429 | $672 | $610 |
Arizona | $314 | $383 | $500 |
Arkansas | $311 | $374 | $458 |
Delaware | $415 | $538 | $529 |
Florida | $346 | $453 | $480 |
Georgia | $304 | $392 | $403 |
Hawaii | $313 | $468 | $450 |
Illinois | $331 | $413 | $464 |
Indiana | $316 | $394 | $527 |
Iowa | $347 | $480 | $465 |
Kansas | $346 | $446 | $477 |
Louisiana | $408 | $512 | $609 |
Michigan | $251 | $335 | $374 |
Mississippi | $408 | $448 | $573 |
Missouri | $355 | $439 | $519 |
Montana | $331 | $449 | $487 |
Nebraska | $446 | $591 | $633 |
New Hampshire | $264 | $305 | $354 |
North Carolina | $342 | $496 | $491 |
North Dakota | $288 | $479 | $448 |
Ohio | $307 | $371 | $441 |
Oklahoma | $355 | $483 | $470 |
Oregon | $329 | $430 | $464 |
South Carolina | $339 | $438 | $483 |
South Dakota | $434 | $592 | $610 |
Tennessee | $338 | $441 | $488 |
Texas | $306 | $415 | $403 |
Utah | $289 | $438 | $486 |
Virginia | $343 | $445 | $435 |
West Virginia | $621 | $752 | $839 |
Wisconsin | $325 | $420 | $445 |
Wyoming | $507 | $745 | $631 |
Source: Mira Health, Kaiser Family Foundation
Ways to Make Insurance More Affordable
- Premium Tax Credit: You will find out if you qualify for a premium tax credit when you apply for coverage, and the amount depends on your estimated household income. This tax credit can be applied to your monthly insurance bill (advanced payments), so you will pay less each month. If you use more advanced payments than qualify, you will have to repay the difference when you file taxes. You will receive the difference as a refundable credit when you file taxes if you use less.
- Cost-Sharing Reductions: Cost-sharing reductions lower the amount you pay for deductibles, copayments, and coinsurance. If you qualify, you must enroll in a silver plan.
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ACA Health Plan Enrollment Frequently Asked Questions (FAQs)
Below are frequently asked questions about enrolling in an ACA health coverage plan.
What Exactly is The Affordable Care Act?
The ACA is a healthcare reform law (also known as ObamaCare) that allows subsidies for consumers to have lower health insurance costs. These consumers are generally households with incomes between 100% and 400% of the poverty level. It also expands Medicaid to cover more adults and supports new medical care to lower general healthcare costs.
What if My Income, Household, or Address Changes?
Once you have enrolled in a health coverage plan, it is important to make updates if your income, household, or address changes. You can report these changes by updating your application online, over the phone, or in person. You need to report such changes because they may cause you to qualify for less coverage. Not reporting changes will lead you to pay it back when you file taxes. Or vice versa, you may miss out on credits where you may be eligible for more coverage and pay fewer monthly premiums.
Who Can Help Me Enroll?
You can find local help and contact someone who is a trained agent, broker, or assistant. You can set up a time to get them through the phone, email, or meet with them in person. They can answer enrollment and coverage options questions and walk you through the application process.
Bottom Line
As open enrollment for health coverage opens, it may be overwhelming to decide what plans to choose and how to apply. To ease the process, it is essential to have your personal and household information and any necessary documents readily available. Further, there are multiple plans to consider when deciding which to choose. If you need guidance, the healthcare marketplace offers resources to help you through the process, whether that be finding out whether you qualify for savings or needing someone to walk you through the application.
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Michelle Fleming is a sophomore at the University of Texas at Austin majoring in Public Health, focusing on biostatistics and informatics and minoring in Health Communications. Michelle is passionate about bridging the gap in health inequalities through advocacy and policy, especially within minority groups.
