Ready, Set, Buy Coverage Through the Health Insurance Marketplace

Melissa Golden

En Español | Kathy S., a self-employed single mother of two, found herself in a tough situation last year. Her COBRA health insurance coverage was due to run out on December 31. Her breast cancer diagnosis in 2012 virtually locked her out of the individual health insurance market. As bad as her situation could have been, Kathy’s timing couldn’t have been better.

Enter the Affordable Care Act’s Health Insurance Marketplace. While the front end of the marketplace was riddled with glitches early on, the new health insurance rules were key for Kathy. As of January 1, insurers could no longer deny coverage or charge more to people with pre-existing conditions.

Even with the glitches, Kathy was able to go online in October and look at plans available to her. “I was able to compare premiums, co-pays and deductibles,” she explained. “I was also able to look up my doctors to see which plans they were in.”

In November, Kathy successfully enrolled in the plan of her choice. Her new coverage will begin January 1, and she qualified for help with her premiums. She’s paying about the same as she was under COBRA.

In California, approximately 5.6 million people are uninsured. They have the opportunity, like Kathy, to buy health insurance through the marketplace.

New this year is a rule that requires most people to carry health insurance or pay a penalty. If you sign up during open enrollment, which ends March 31, you will avoid the penalty. If you already have coverage through Medicare or Medicaid, a military program or your employer, you don’t need to do anything.

Here’s Kathy’s advice on how to get ready to apply for coverage through the Health Insurance Marketplace:

1. Gather the following information:
• Social Security number of each family member
• Employer and income information for everyone in your family (from your tax return, pay stubs or W-2). This information will go into determining if you are eligible for  financial help to pay for some of the costs.
• The policy number for any current health coverage
• Information about job-related health insurance available to you or your family
2. Prepare a list of your health care providers as well as your pharmacies and local hospital. You can refer to it to make sure the health plan you choose includes them.
3. If your household files more than one tax return, call 800-300-1506 before you start an application.
4. When you’re ready, visit www.CoveredCA.com and start shopping. If you need help, call 800-300-1506.

You can also apply by phone or print the application and mail it in. If you want in-person help with the process, you can get that, too. The website provides information about all the ways you can apply.

Oh, and if you have adult kids who may need a nudge to sign up for health insurance before March 31, send them a funny e-card.

To learn more about the Health Insurance Marketplace and the health care law’s benefits and protections, visit www.HealthLawAnswers.org or for Spanish speakers, www.MiLeyDeSalud.org.


Nicole Duritz is Vice President of the Health & Family issues team in the Education and Outreach group at AARP.  She leads AARP’s educational and outreach efforts on health education issues, including Medicare, the health law, prescription drug affordability, long-term care, and prevention and wellness. She can be reached at nduritz@aarp.org.