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Find out what Marketplace health plans cover

All Marketplace plans cover the same set of essential health benefits, preventive care, and pre-existing conditions. Starting November 1 you can enroll in or renew a plan for 2019, so you’ll continue to have access to these benefits.

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What are essential health benefits?

  • Essential health benefits are a set of 10 categories of services — including doctor's visits, inpatient and outpatient hospital care, prescription drugs, pregnancy and childbirth, mental health, and more — that health insurance plans must cover.
  • Plans must also offer birth control and breastfeeding coverage.
  • These are the minimum requirements for all Marketplace plans. Plans may offer more benefits. You’ll see exactly what’s covered when you compare plans.

What’s preventive care?

  • Most health plans must cover a set of preventive services — like shots and screening tests — at no cost to you.
  • Preventive services are used to prevent illnesses, disease, and other health problems, or to detect illness at an early stage when treatment is likely to work best.
  • These services are free only when delivered by a doctor or other provider in your plan’s network.

What’s coverage for pre-existing conditions?

  • All Marketplace plans must cover treatment for pre-existing medical conditions, like asthma, diabetes, or cancer.
  • Marketplace plans can’t deny you coverage or raise your rates based only on your health.
  • Pregnancy is also covered from the day your plan starts.

Open Enrollment is less than one month away!

You have less than one month until you can start enrolling in a 2019 Marketplace health insurance plan. See important dates to remember, and learn things you can do now to prepare.

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Important dates to know

  • The 2019 Open Enrollment Period runs from November 1 to December 15, 2018. This means you have six weeks to enroll in or renew a plan.
  • Plan coverage starts January 1, 2019.

Get ready today to apply November 1

  • Gather everything you need to apply by using this checklist (PDF).
  • Review quick tips about the Health Insurance Marketplace.
  • Return to shortly before Open Enrollment starts to preview 2019 health plans and prices before you apply.

Stay healthy with your free flu shot this fall

The Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months and older get a flu shot every year. With your Marketplace health plan, your flu shot is free from a provider in your plan's network.

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Quick answers about the flu shot

  • Why get vaccinated: The flu shot helps keep you and the people around you healthy. According to the CDC, getting the flu shot lowers the risk of flu illnesses, doctor's visits, hospitalizations, and missed work and school.
  • When to get vaccinated: It’s best to get the shot before the flu starts spreading in your community, so try to get it by the end of October. Flu viruses are most common in the fall and winter.
  • Where to go: Getting the flu shot may be more convenient than you think. Enter your ZIP code to find a clinic near you.
  • How much it costs: Most health plans cover a set of preventive services — including the flu shot — at no cost to you when delivered by a doctor or provider in the plan’s network.

Get more flu information from the CDC.

What to look for when comparing plans

Open Enrollment for 2019 health coverage starts November 1. Knowing just a few things before you apply can make choosing a plan simpler and easier.

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3 things to know about picking a health insurance plan

  • There are 4 categories of health insurance plans: Bronze, Silver, Gold, and Platinum. These categories show how costs are shared between you and your plan. Plan categories have nothing to do with quality of care.
  • It’s important to think about your total health care costs, not just the premium. Other out-of-pocket costs have a big impact on your total health care spending — sometimes more than the premium. Get more information on how these costs work together to make up your total spending.
  • There are different types of Marketplace health insurance plans designed to meet different needs. Some plans may limit your provider choices or encourage you to get care from the plan’s network of doctors, hospitals, pharmacies, and other medical providers. Other plans may pay a greater share of costs for providers outside the plan’s network. Learn more about health insurance plans and network types.

Before you come back to apply for 2019 coverage on November 1, get more tips on picking a health insurance plan that’s right for you.

3 ways to get ready for 2019 Open Enrollment

Open Enrollment starts November 1. Here’s what you can do now to make the application process smoother.

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3 easy ways to prepare for 2019 Open Enrollment

  • Gather everything you need before you apply. When you apply for or renew your coverage, you’ll be asked to give household, income, and current coverage information. Save yourself time and stress by reviewing this Marketplace checklist (PDF) in advance to make sure you have everything you need.
  • If you have 2018 Marketplace coverage, review your current application to make sure it's still accurate. If it’s not, update your application with any income and/or household changes. If you don’t update your application, you might not get the right amount of premium tax credit or other savings. Starting November 1, you can access your pre-filled 2019 application based on the information you gave for 2018.
  • Set an Open Enrollment deadline reminder. Open Enrollment ends December 15. If you have a 2018 Marketplace plan, you may be automatically enrolled in the same plan (or a similar one) for 2019 if you don’t act by the deadline. This may not be your best option, so be sure to compare all available plans. Mark December 15 on your calendar so you don’t miss out on a plan that may be a better fit for you for 2019.

Never miss a deadline with 2019 Open Enrollment reminders

Open Enrollment for 2019 Marketplace health insurance runs November 1–December 15. Connect with us today so you don’t miss out on deadline reminders, useful tips, and other information about your health coverage.

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Stay up-to-date with the Marketplace

  • Subscribe to email or text updates. Visit the homepage and enter your email address under “Get Important News & Updates.” Click “Sign Up.”
  • Find someone in your area to answer questions. Assistors in your community with special Marketplace training are available to help you. Enter your ZIP code to see a list of groups and people near you.
  • Connect with us on social media. Follow us on Twitter and like us on Facebook for the latest updates.

When can I enroll in a 2019 Marketplace plan?

Open Enrollment for 2019 Marketplace coverage starts in just a few short months. Here are some important enrollment dates to mark on your calendar:

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Key 2019 Open Enrollment dates

  • The 2019 Open Enrollment Period runs from Thursday, November 1, 2018, to Saturday, December 15, 2018.
  • If you don’t act by December 15, you can’t get 2019 coverage unless you qualify for a Special Enrollment Period.
  • Plans sold during Open Enrollment start January 1, 2019.

For other essential enrollment information, get a quick overview of the Health Insurance Marketplace.

Heading back to school? See student health insurance options

As you get ready for the upcoming school year, don’t leave health insurance off your back-to-school checklist. Getting health insurance may be more affordable — and simpler — than you think. As a college student, there are several options available to you:

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Ask your college about student health plans

Stay on your parent’s plan if you’re under 26

  • If a parent’s health insurance plan covers dependents (no matter whether they got their plan through their job or the Marketplace), you usually can be added to their plan and stay on it until you turn 26.
  • Learn more about staying (or getting on) a parent’s plan.

Get your own Marketplace plan

  • At, you’ll find a variety of plans and prices available to you. Depending on your situation, you may be eligible for savings based on your income. But if someone will claim you as a tax dependent on next year’s tax return, you won’t be eligible for extra savings.
  • You may be able to get coverage for the rest of 2018 if you qualify for a Special Enrollment Period. Answer a few fast questions to find out.
  • If you don’t qualify, you can apply for a 2019 Marketplace plan starting November 1.

3 ways to use your health plan when you’re feeling well

Health insurance isn’t only for when you’re sick. You can use it to maintain your health. Understanding how your coverage works before you need care can also make things easier if you get sick.

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Take advantage of free insurance benefits anytime

  • Get preventive services, like the flu shot or a depression screening, that are right for you.
  • Being proactive with preventive care can prevent illnesses, diseases, and other health problems, or detect illness at an early stage when treatment is likely to work best.
  • These services are free when delivered by a doctor or other provider in your plan’s network.

Even if you don’t need care right now, find a doctor you can trust

  • Taking the time to find a doctor you trust when you’re feeling well can save you stress when you get sick.
  • You usually pay less if you choose a doctor in your network. Visit your health plan’s website and check the provider directory to see who’s in your network.

Understand your costs before you need care

  • It’s important to learn which services in your plan aren’t subject to your health insurance deductible.
  • Some plans charge only a copayment for primary care visits before you meet your deductible; others offer discounts on drugs, including generic drugs.
  • Knowing your costs up front can prevent the stress of unexpected costs later on.

Have a pre-existing condition? Your health coverage isn't affected

Did you know all Marketplace plans must cover treatment for pre-existing medical conditions, like asthma, diabetes, and cancer?

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What’s a pre-existing condition?

  • A pre-existing condition is a health problem you had before the date that your new health coverage starts.
  • Pre-existing conditions include epilepsy, cancer, diabetes, lupus, sleep apnea, and many more.

Can a health insurance company deny me or charge me more for my pre-existing condition?

  • No. An insurance company can’t deny you, charge you more, or refuse to pay for essential health benefits because of any condition you had before your coverage started.
  • Also, Marketplace plans can't put annual or lifetime limits on your coverage.
  • Learn more about coverage for pre-existing conditions.

Is pregnancy treated as a pre-existing condition?

  • Yes. If you were pregnant before you applied, your insurance plan can't reject you or charge you more because of your pregnancy.
  • Once you're enrolled, your pregnancy and childbirth are covered from the day your plan starts.
  • Get more information on coverage for pregnancy and childbirth.


News – Insurance Journal

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Washington Packing House to Pay $525K in Sexual Harassment Settlement
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Farmers in Hawaii Lost $28M Because of Volcano
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Delaware Workers’ Comp Insurance Rates Decrease for Second Year in a Row
Workers’ compensation insurance rates will decrease for the second year in a row in Delaware, effective December 1, 2018. “I am delighted to approve yet another decrease in workers’ compensation rates in Delaware and even happier to see a double-digit …

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Wells Fargo Will Pay $65M Penalty to New York Over Cross-Selling Practices
Wells Fargo & Co. will pay a $65 million penalty to New York state related to its cross-selling practices. The bank failed to disclose to investors that the success of its cross-selling – the pitching of additional financial products to …

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