Gundersen answers your questions about the Health Insurance Marketplace.
What is the Health Insurance Marketplace?
The Marketplace is an online portal where you can shop for health insurance plans that fit you or your family's needs. You can compare plans based on price, benefits, quality, and other features important to you before you decide which plan to purchase.
What is the Marketplace in my state?
If you live in Wisconsin or Iowa, visit www.healthcare.gov for the Marketplace. If you live in Minnesota, visit www.mnsure.org.
Is there a phone number I can call?
- For Wisconsin residents: (800) 318-2596, 24 hours a day, 7 days a week. (TTY: (855) 889-4325
- For Iowa residents: (800) 318-2596, 24 hours a day, 7 days a week. (TTY: (855) 889-4325)
- For Minnesota residents: (855) 366-7873
Who qualifies for the Marketplace?
Most people will be eligible for health coverage through the Health Insurance Marketplace. To be eligible for health coverage through the Marketplace, you:
- Must live in the United States
- Must be a U.S. citizen or national (or be lawfully present)
- Can't be currently incarcerated
What if someone doesn't have health coverage?
If someone who can afford health insurance doesn't have coverage, they may have to pay a fee. They also have to pay for all of their healthcare. The fee increases every year. It's important to remember that someone who pays the fee will not have any health insurance coverage. They still will be responsible for 100% of the cost of their medical care. You cannot sign up for health coverage through the Marketplace outside of an open enrollment period, unless you have a qualifying life event (marry, divorce, have a baby, move to a new coverage area).
When can I sign up?
The next open enrollment period begins November 1 and runs through December 15.
Why should I have health insurance?
Having health coverage can help protect you from potentially high costs associated with health care. Insurance coverage protects you from high medical costs two ways:
- Out-of-pocket maximum: This is the total amount you'll have to pay if you get sick. For example, if your plan has a $3000 out-of-pocket maximum, once you pay $3000 in deductibles, coinsurance, and co-payments the plan will pay for any covered care above that amount for the rest of the year.
- No yearly or lifetime limits: Health plans in the Marketplace can't put dollar limits on how much they will spend each year or over your lifetime to cover essential health benefits. After you've reached your out-of-pocket maximum, your insurance company must pay for all of your covered medical care with no limit.