To enroll in health insurance in the Affordable Care Act (ACA) Marketplace, you must meet a few basic qualifications. If you don’t already have health insurance through a job or other source, such as Medicare or Medicaid, you may be able to get coverage through the ACA Marketplace.
In order to enroll in a health insurance plan in the ACA marketplace, you must:1
Living in the U.S. means residing in one of the 50 U.S. states or Washington, DC. In order to apply for ACA Marketplace coverage, you must provide an address. People without an address or those experiencing homelessness can provide the address of a family member, friend, or shelter in the state they are seeking health care services.2 A P.O. Box also counts for an address.
For more information about immigration statuses that qualify for the ACA Marketplace, check the HealthCare.gov website.
There is no income limit to qualify for the ACA Marketplace.3 This means there is no minimum or maximum income required to be eligible for Marketplace coverage.
Young people are eligible to stay on their parent’s health plan until they are 26 years old. After that, they need to get their own coverage. Young people who don’t have job-based insurance can apply for coverage through the ACA Marketplace.
Options for applying for ACA Marketplace health insurance plans depend on whether their parent had health insurance through their job or the Marketplace.
The ACA requires all health insurance plans, inside or outside the ACA Marketplace, to provide coverage for people with pre-existing conditions.5 This means that having a pre-existing condition doesn’t prevent you from qualifying for health insurance through the ACA Marketplace. Furthermore, health insurance plans can’t charge you more because of a pre-existing condition.
The ACA Marketplace provides health care coverage options to people who don’t already have health insurance. Federally sponsored health plans, such as Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP), are their own forms of health insurance and are not part of the ACA Marketplace.
If you have Medicare, you don’t need to change anything. You can’t be on Medicare and enroll in the Marketplace.6 You may be able to choose private health insurance through the Marketplace instead of Medicare in a few select situations.
Medicaid and CHIP are also separate from the ACA Marketplace. If you lose or are denied Medicaid or CHIP coverage, you can apply for ACA Marketplace coverage. In this case, you may be eligible for savings with Marketplace health plans.
When you enroll in the ACA Marketplace, you need to provide information about you and anyone else you are applying for health care coverage for.
Here is a general list of the type of information you will need to provide:8
The Open Enrollment period for the ACA Marketplace happens every year from November 1 to January 15.9 If you enroll by December 15, your health insurance starts January 1. If you enroll between December 16 and January 15, your plan starts February 1. You must pay your first premium for your health insurance to start.
You may be eligible to apply for ACA Marketplace outside the open enrollment period if you have certain life events. This is called a Special Enrollment Period. Examples of qualifying life events include:10
Source: https://www.verywellhealth.com/who-qualifies-for-the-aca-11757178
