SECTION

Navigating Health Insurance Marketplace Options

Health insurance marketplaces (also known as Exchanges) are organized markets for buying health insurance. They offer a choice of different health plans, certify plans that participate and provide information to help consumers better understand their options. Through the marketplace, individuals and families are able to shop for coverage if they need to buy health insurance on their own. Premium and cost-sharing subsidies are available through the marketplace to reduce the cost of coverage for individuals and families, based on their income. Individuals and families with very low incomes are able to find out at the marketplace if they may be eligible for coverage through Medicaid and CHIP.

There is a health insurance marketplace in every state for individuals and families. Some marketplaces are operated by the state and have a special state name (such as Covered California or The Maryland Health Connection.) In other states where the federal government runs the marketplace, it will be called The Health Insurance Marketplace of [state name].

Links to all state marketplaces can be found here.

A Small Business Health Options Program (SHOP) marketplace is also available for small businesses, but unlike marketplaces for individual coverage, employers are required to enroll in the SHOP with the help of an agent or broker, or directly through an insurer on the federally facilitated marketplaces and some state-based marketplaces. Other state-based marketplaces may offer a platform for eligibility determinations and enrollment. See this FAQ for more information about SHOP and this FAQ for more information about the small business health care tax credit.