How to enroll, step by step
Three routes, all reaching the same plans at the same prices. The step people miss is the last one.
There are three ways to enroll in a marketplace plan, and they all reach the same plans at the same prices. An insurer may not charge you more for using one route rather than another, so the choice is purely about how much help you want.
The three routes
- HealthCare.gov directly. Free, official, and entirely self-service. Best if your situation is straightforward and you are comfortable comparing plans yourself.
- A licensed agent or broker. Also free to you — agents are paid a commission by the insurer, which is built into the premium whether or not you use one. Best if your income is complicated, you have doctors you need to keep, or you would rather talk it through.
- A Navigator or certified assister. Free, grant-funded, and not paid by insurers. They can help you apply but are not permitted to recommend a specific plan.
The number on this site reaches a licensed agent, and HealthPlanIndex is paid for that connection. Say so once and clearly: it is route two, and route one is always available to you at no cost.
The steps
- Create or log into your account at HealthCare.gov. Returning users should check the household details rather than clicking through them — last year's income estimate is still sitting there.
- Complete the application. Household, income, and whether anyone can get coverage elsewhere. What you need to hand.
- Read the eligibility result. It tells you your credit, and whether anyone qualifies for Medicaid or CHIP instead. It also tells you whether you qualify for cost-sharing reductions — which only apply to silver plans, and change which plan is actually the best value.
- Compare plans on total cost, not premium. Add the annual premium to the deductible you would realistically hit. Then check each candidate plan's network for your doctors and its formulary for your prescriptions, individually. Plans in the same tier and the same county differ on both.
- Enroll, then pay the first premium. This last step is the one that gets missed. Coverage does not begin until the first premium is paid, no matter what the confirmation screen said. Insurers set their own deadline for it.
Selecting a plan is not the same as being covered. Every year people believe they enrolled, never paid the binder premium, and find out at a pharmacy counter. Diary the payment.
After you enroll
- Report income and household changes when they happen. A new job, a raise, a marriage, a birth. The credit adjusts going forward, which is far less painful than reconciling it in April.
- Keep Form 1095-A when it arrives in the new year. You need it to file, and the return will not reconcile without it.
- Use the plan. Preventive care that is on the required list — screenings, immunizations, an annual wellness visit — is covered with no cost-sharing when you use an in-network provider.