Here are some important enrollment tips if you are considering applying for coverage on the Individual Marketplace.
Should I apply for Coverage on the Marketplace?
The Marketplace is the only way to get taxpayer subsidized insurance. You are generally NOT eligible subsidies if you are eligible for other coverage such as Medicare, Medicaid, or Employer Sponsored Group Coverage and if your household income is outside the ranges below.
If you do NOT qualify, purchasing health insurance on the Marketplace is a big hassle and a waste of time. Health insurance can be purchased easily off the Marketplace and you will find choices that are not available on the Marketplace.
If I think I qualify for subsidies, how do I apply on the Marketplace?
Currently there are 3 ways to apply.
On the Web at Healthcare.gov
On the phone at 800-318-2596
Marketplace Paper Application
Currently the Government’s website does not properly function. I have personally completed the subsidy application but am unable to see my determination or see any plan options online.
I have also called the help line at 800-318-2596. The operators are very helpful; however, they have indicated they use the same system as the online process so this may fail as well.
I really think I could benefit and want to apply, what should I do?
Applying for premium subsidies is similar to applying for a loan, you will need to have certain information available. If you want to apply, it is important that you are prepared.
If you want the assistance of a broker, either to help make a plan selection or if you want help with future problems such as claims, billing, you will need to provide the brokers Federally Facilitated User ID (FFM ID) and National Producer Number (NPN). This can be provided using any application method (i.e. Internet, phone, or paper)
Mine are as follows:
FFM User ID: firstname.lastname@example.org
Make sure you have your financial information for everyone in the household, this will include things like:
- Social Security Numbers (or documents for legal immigrants)
- Employer & income information for everyone in the household. (This could be tax returns, pay stubs, etc.)
- Information about any employer based health coverage offered to anyone in your household.
- If you are married, you must file a joint tax return in order to be eligible for subsidies.
The system is supposed to present you a range of options based on your situation. Since this doesn’t seem to work, I think it’s a good idea to figure out what you will likely want ahead of time.
Make sure you have plenty of time. When I spoke to the operators they told me that a successful application process can take 2 hours.
If you have tried the web based or phone process but were unsuccessful, you may want to try the paper process.
I have a Marketplace Paper Application available. These are applications to qualify for premium subsidies. They are NOT actual applications for coverage. Under the paper method, you submit the subsidy application and wait for a response from the Marketplace with further instructions. You would select your coverage once a determination is made about your eligibility for subsidies.