To determine eligibility for Affordable Care Act (ACA) insurance or Marketplace insurance, individuals must meet certain requirements. These include:

• Lack of access to affordable health insurance through an employer or a government program like Medicare or Medicaid.
• Residency as a U.S. citizen or legal resident residing in the United States.
• Not being currently incarcerated.
• Meeting specific income criteria, which can vary depending on the state.

ACA Marketplace plans provide a comprehensive range of essential health benefits to ensure individuals receive necessary medical care. These benefits include:

• Outpatient care (ambulatory patient services)
• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health and substance use disorder services
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services, as well as chronic disease management
• Pediatric services, including oral and vision care

To initiate the enrollment process for an individual ACA Marketplace health insurance plan, it is recommended to engage in a conversation with a licensed representative from HCS Help. By providing relevant details such as income, zip code, and any pertinent information about your health, our team will handle the remaining procedures. This includes the ability to explore the available plans in your region, compare their coverage

There are multiple enrollment periods for ACA Marketplace plans, depending on your circumstances:

• Open Enrollment Period: The annual Open Enrollment Period generally takes place from November 1st to December 15th. During this time, you can enroll in an ACA Marketplace plan.
• Special Enrollment Period: If you experience a qualifying life event, such as marriage, the birth of a child, or the loss of other health coverage due to factors like job loss, you may be eligible for a Special Enrollment Period. This allows you to enroll outside the regular Open Enrollment Period.
• Native American Health Services: If you are a member of a federally recognized tribe, you have the flexibility to enroll in or change your health coverage at any time throughout the year.
• Income-based Enrollment: A new, temporary Special Enrollment Period (SEP) has been established to allow individuals with specific income levels to enroll in ACA Marketplace plans year-round.