Enrolling in the Health Insurance Marketplace

What is the Health Insurance Marketplace?

The Health Insurance Marketplace was created through the Affordable Care Act as a place where consumers can shop, apply and enroll in health insurance. The marketplace determines eligibility for these programs, tax subsidies, and cost sharing reductions based on your income, household size and immigration status.

By law you cannot be denied coverage due to a pre-existing health condition like cancer or diabetes.

At the Health Insurance Marketplace you can:

  • Explore dozens of health plans in your area and compare them side-by-side in easy to understand language
  • See what your premium, deductible, and out-of-pocket costs will be before you enroll
  • Discover if you can get lower costs based on your income and family size

When can I sign up?

There are two times when you can sign up for coverage:

  • During Open Enrollment.
  • When you have a Qualifying Life Event such as losing work-based coverage, moving to a new area, a change in family size, and more.

How can Mercy's Certified Application Counselors help?

Mercy's Certified Application Counselors are trained professionals, licensed with the State of Tennessee, who can assist consumers through each step of the application and enrollment process.

Their role is to help consumers understand their options and to be a fair, unbiased resource acting in the best interest of the consumer. They are not affiliated with any insurance company.

Here are some situations that they can help with:

  • Understanding and completing an application including what each plan offers
  • Explaining how tax credits could lower your monthly insurance payment (premium)
  • Appealing the eligibility determination
  • Filing for an exemption from the requirement to purchase coverage (some restrictions apply)
  • Determining if you qualify for a Special Enrollment Period

What are the steps to enrollment?

  • Social security numbers for everyone applying for coverage (or document numbers for legal immigrants)
  • Employer and income information for every member of your tax-filing household (For example, wage and tax statements from pay stubs and W2 forms.)
  • Policy numbers for any current health insurance plans covering members of your household
  • Completed “Employer Coverage Tool” for which every job-based plan you or someone in your household is eligible

TennCare and CoverKids

In the state of Tennessee, applications for TennCare and CoverKids are also completed through the Marketplace. The Marketplace will determine your eligibility for these programs and then forward the application onto either TennCare or CoverKids for a final decision.

The information you provide will affect your tax return, so it is very important to provide accurate information.

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