The simplest way to think of health insurance exchanges is think of them like a Walmart, Target, Cosco, Kroger, etc. or even more similar - Amazon.com. The health exchange is an online place to shop for health insurance, where insurance companies (like Blue Cross, Humana, UnitedOne, etc) can elect to have their health plans available for enrollment Some states have their own exchanges in which they received federal dollars to operate, while other states opted for the federal government to handle the exchange through healthcare.gov. Just as anyone can walk into a Walmart or log on to Amazon.com, anyone can log on to an exchange and shop for health insurance. The plans on the exchange may be limited in the number of doctors & hospitals in the network in order to save premium dollars. For example, in TN, BCBS launched their "E" network, which has roughly 5000 providers state wide, where their other networks have ~45,000 & ~55,000 providers. The premiums for the "E" network are significantly lower. An insurance company may have addition plans available if you purchase directly through them. This is typically called off-marketplace, while enrolling through the exchange is on-marketplace. So... if you had more choices off-marketplace, why would anyone want to enroll in a plan through the marketplace/health insurance exchange? You can only obtain the government premium subsidy through the exchange. In other words, depending on your income, you could pay less through the marketplace. When you register, for example at healthcare.gov, there will be an opportunity for you to input your income from the previous year. If you are under 400% (about $44k for individual) you could qualify for the subsidy, reducing the premium you would have to pay for your plan. After the insurance company receives your part of the payment, the insurance company tells the government you have paid & then the government pays the subsidy, so you get immediate relief. One final thought... open enrollment ended 03/31, so unless you have lost coverage involuntarily or had another qualifying event, you would be ineligible to enroll in individual health insurance until the next open enrollment.
Any person eligible to purchase health insurance in the United States, with the exception of persons qualifying for Medicaid and/or Medicare is technically eligible to use the government health insurance marketplaces. Whether you would want to or whether it would make any sense for you to use them are other issues entirely.
The government marketplaces will help determine if you would qualify for any premium tax subsidy for coverage purchased through their system. If you qualify for little or no premium subsidy then you may find that the government marketplaces may not best meet your needs. You will probably have larger selection of insurance carriers as well as possibly health plan and network options you may not find in the government marketplace. You should seek out the services of a health insurance broker to help find the best coverage for your situation.
If you have coverage provider by an employer, and this coverage is deemed affordable under the terms of the Affordable Care Act,(cost doesn't exceed 9.5% of your W2 income) then neither you nor your eligible dependents will be eligible for premium tax subsidies in the government marketplaces. This does not preclude someone from purchasing individual health insurance inside or outside of the government marketplaces and in some cases buying unsubsidized individual coverage for a dependent may be less expensive than adding them as a dependent onto your group plan.
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The government marketplaces will help determine if you would qualify for any premium tax subsidy for coverage purchased through their system. If you qualify for little or no premium subsidy then you may find that the government marketplaces may not best meet your needs. You will probably have larger selection of insurance carriers as well as possibly health plan and network options you may not find in the government marketplace. You should seek out the services of a health insurance broker to help find the best coverage for your situation.
If you have coverage provider by an employer, and this coverage is deemed affordable under the terms of the Affordable Care Act,(cost doesn't exceed 9.5% of your W2 income) then neither you nor your eligible dependents will be eligible for premium tax subsidies in the government marketplaces. This does not preclude someone from purchasing individual health insurance inside or outside of the government marketplaces and in some cases buying unsubsidized individual coverage for a dependent may be less expensive than adding them as a dependent onto your group plan.