If you are seeking individual coverage through the Government or State Exchanges you may only enroll in new coverage during the Government Open Enrollment Period. You can only enroll in coverage outside of that time period if you have a qualifying life event. Events that are considered acceptable qualifying life events (QLE) include:

• permanently moving to a new state
• job loss
• family changes (marriage, divorce, birth of a child)
• loss of existing health coverage because of a job loss or job change
• loss of eligibility for Medicaid or CHIP
• expiration of your COBRA benefits

While health insurance is no longer required at the federal level, there is a possibility that you will face a tax penalty for not having adequate coverage if you live in a state that has an individual mandate.

Right now, there are five states and one district where health insurance is required. You may be subject to a tax penalty if you live in one of the following areas and do not have medical insurance coverage:

• Massachusetts
• New Jersey
• Vermont
• California
• Rhode Island
• District of Columbia (Washington D.C.)

Government subsidies are available to help individuals with the cost of purchasing health insurance coverage through a marketplace. To qualify for a subsidy your income must be between 100% and 400% of the government poverty level. Subsidies are paid directly to the insurers to help lower premium costs. However, subsidies are structured so that the most qualifying individuals or families will have to pay towards their premiums will range from 2.0% to 9.5% of their income.

All plans offered through the exchanges must provide minimum essential benefits and provide certain preventive services. The four types of plans available on the public exchanges are referred to as "metallic plans" because they are named after four types of metals:

• Bronze - pays for 60% of all covered costs
• Silver - pays for 70% of all covered costs
• Gold - pays for 80% of all covered costs
• Platinum - pays for 90% of all covered costs

Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

All Marketplace plans and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance.

• Abdominal Aortic Aneurysm
• Alcohol Misuse screening and counseling
• Aspirin use to prevent cardiovascular disease for men and women of certain ages
• Blood Pressure screening for all adults
• Cholesterol screening for adults of certain ages or at higher risk
• Colorectal Cancer screening for adults over 50
• Depression screening for adults
• Diabetes (Type 2) screening for adults with high blood pressure
• Diet counseling for adults at higher risk for chronic disease
• HIV screening for everyone ages 15 to 65, and other ages at increased risk
• Immunization vaccines
• Obesity screening and counseling for all adults
• Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
• Syphilis screening for all adults at higher risk
• Tobacco Use screening for all adults and cessation interventions for tobacco users

Yes. However, plans purchased outside of the state and government exchanges are not eligible for government subsidies.

Although Medicaid is financed by the federal government it is a state sponsored program which means you need to meet your states eligibility requirements in order to qualify. Generally, you should qualify for Medicaid if your household income is less than 100% of the Government Poverty Level . Many states have expanded coverage to include everyone earning up to 133% of the Government Poverty Level. You can find out if you qualify using our Coverage Calculator.