Links Roundup: All Links From the Jensurance Website & Marketplace E-Book
Carefully selected links about all topics surrounding the Health Insurance Marketplace®
This list has been closely evaluated to make sure the information provided is accurate and impartial. I hope you’ll find it useful and informative, and that this gives you a place to start when you need information on a specific topic.
This collection includes helpful links from both the entire Jensurance website (including blog posts) AND the Jensurance exclusive e-book: Obamacare? Marketplace? The Exchange?: A Comprehensive Guide (follow the link to download your FREE copy! COMING SOON!)
Some links may appear more than once in different categories. I will be doing routine maintenance to make sure the links aren’t broken but in case I miss something, please email me and let me know. I welcome any feedback. Even if you just think one of the links isn’t useful or helpful as suggested by its title or topic, I’d like to hear about that as well.
NOTE: As you go through this page, and possibly some others in the site, there may be some hyperlinks that aren't linked yet. Please bear with me. I'm publishing all of this myself and trying to get it done at once as much as I can but it's not always possible. Check back and I assure you the content you're looking for will be linked! As the sole proprietor of my business, I am the web design team as well as all other roles, so sometimes things don't roll out as seamlessly as I'd prefer but I do enjoy being able to do it myself and make it a more personal experience. Thank you so much for your patience!
About the Affordable Care Act (ACA)
- Health Insurance Marketplaces®: 10 Years of Affordable Private Plan Options
- Rights & Protections | HealthCare.gov
- The Affordable Care Act: Increasing Transparency, Protecting Consumers | CMS
- 6 Key Accomplishments from the Affordable Care Act – Third Way
- About the ACA | HHS.gov
- What is the Health Insurance Marketplace? | HHS.gov
- What Is a Qualified Health Plan (QHP)?
- Find out what Marketplace health insurance plans cover | HealthCare.gov
- Exchange - Glossary | HealthCare.gov
- What’s the difference between Medicare and Medicaid? | HHS.gov
- SHOP Coverage for Employers | HealthCare.gov
Consumer protections provided by the ACA
- Marketplace health plans cover pre-existing conditions | HealthCare.gov
- Preventive health services | HealthCare.gov
- Health Care Coverage Options for Young Adults | HealthCare.gov
- Ending Lifetime & Yearly Limits | HealthCare.gov
- Summary of Benefits and Coverage | HealthCare.gov
- Rate Review & the 80/20 Rule | HealthCare.gov
- Cracking Down on Frivolous Cancellations | HealthCare.gov
- Doctor Choice & Emergency Room Access | HealthCare.gov
- Protection from employer retaliation | HealthCare.gov
- Rights & Protections | HealthCare.gov
- Find out what Marketplace health insurance plans cover | HealthCare.gov
Official text of the ACA
- Are you eligible to use the Marketplace? | HealthCare.gov
- What is the Health Insurance Marketplace? | HHS.gov
- Find out what immigration statuses qualify for coverage in the Marketplace | HealthCare.gov
- Health coverage for lawfully present immigrants | HealthCare.gov
- Health coverage options for incarcerated people | HealthCare.gov
- Learn what to do if you already have Medicare health coverage | HealthCare.gov
- Get help applying & more | HealthCare.gov
- What’s the difference between Medicare and Medicaid? | HHS.gov
Premiums, metal levels, and types of plans
- What is individual health insurance? | healthinsurance.org
- How Health Insurance Marketplace® Plans Set Your Premiums | HealthCare.gov
- Understanding Metal Levels and Marketplace Insurance – HealthSherpa Blog
- HMO, PPO, EPO, POS–Which Plan Should You Choose?
- Catastrophic health plans | HealthCare.gov
- Health plan categories: Bronze, Silver, Gold & Platinum | HealthCare.gov
- Health insurance plan & network types: HMOs, PPOs, and more | HealthCare.gov
- Understanding "In-Network" and "Out-of-Network" Providers | Renown Health
- https://www.cms.gov/files/document/nosurpriseactfactsheet-health-insurance-terms-you-should-know508c.pdf
- Your total costs for health care: Premium, deductible, and out-of-pocket costs | HealthCare.gov
- What is balance billing? | healthinsurance.org
- What's a Health Savings Account? | CMS
- What is a Service Area? - Definition from Insuranceopedia
- Usual, Customary and Reasonable Fees: What They Are, How They Work
- Wellness Program: Meaning, Criticisms, Example
Cost sharing (deductibles, copays, coinsurance, out-of-pocket max) EXCELLENT reference
For comparing total cost of health plans
Formularies
- https://www.goodrx.com/insurance/health-insurance/medication-formulary
- Generic Drugs: Questions & Answers | FDA
- How Does a Prescription Drug Tier List (Formulary) Work? | MetLife
Out-of-pocket costs & OOP max
Types of plans
- Point-of-Service (POS) Plan: Definition, Pros & Cons, Vs. HMO
- Preferred Provider Organization (PPO): Definition and Benefits
- What is balance billing? | healthinsurance.org
- Find out what Marketplace health insurance plans cover | HealthCare.gov
Primary Care
- What is a Primary Care Provider (PCP)?
- Primary Care | CMS
- How to Get a Primary Care Appointment Sooner
Referrals
View Marketplace insurance carriers by state
Post Enrollment Resources from Top Marketplace Insurance Carriers
As presented in Jensurance’s own Obamacare? Marketplace? The Exchange?: A Comprehensive Guide e-book, part 3.1
- Aetna Member Benefit & Service FAQs
- What to Expect for Members | Ambetter from Superior HealthPlan
- Member Resources | Baylor Scott & White Health Plan
- To Do After Enrolling in Healthcare Coverage | Blue Cross and Blue Shield of Texas
- Registration | myCigna
- Member Guide | Cigna Healthcare
- Welcome to Community Health Choice
- My Member Account - Community Health Choice
- Humana Member Support: Find Resources and Services
- Activate and Manage Your MyHumana Account | Humana
- Moda Health member welcome page
- My Molina
- Getting started as an Oscar member
- Members waiting for coverage to start | Member resources | UnitedHealthcare
- New member checklist | Member resources | UnitedHealthcare
- Welcome new Wellpoint members
- Improving your health | HealthCare.gov
- Explore your health care options after Open Enrollment | HealthCare.gov
Filing health insurance claims
Paying your first premium after enrollment
- Low Cost Marketplace Health Care, Qualifying Income Levels | HealthCare.gov
- Advance Payments of the Premium Tax Credit (APTC) and Cost-Sharing Reductions (CSRs) Overview | CMS
APTC (Advance Premium Tax Credit) & PTC (Premium Tax Credit)
- Advance Payments of the Premium Tax Credit (APTC) and Cost-Sharing Reductions (CSRs) Overview | CMS
- Questions and answers on the Premium Tax Credit | Internal Revenue Service
- The Premium Tax Credit – The basics | Internal Revenue Service
- How much can I earn and qualify for premium tax credits in the Marketplace? | KFF
- 3.4 Advanced Premium Tax Credit (APTC): What It Is & How to Reconcile (a subsection of Part 3 of the Obamacare? Marketplace? The Exchange?: A Comprehensive Guide ebook)
Income limits to qualify for PTC (premium tax credits)
Changes in circumstances that can affect APTC
Reconciling at tax time
CSRs (Cost Sharing Reductions)
2025 Federal Poverty Level (FPL) Guidelines
Annual Open Enrollment Period (OEP)
Special Enrollment Periods (SEP)
- Special Enrollment Periods (SEPs) & Qualifying Life Events (QLEs) (part 3.3 of OME: Comprehensive Guide)
- Getting health coverage outside Open Enrollment | HealthCare.gov
- Find out if you can get health coverage now
- Why the Marketplace asks for more information | HealthCare.gov
- Special Enrollment Periods for Complex Health Care Issues | HealthCare.gov
- How do I file an appeal? | HealthCare.gov
The following section includes the links from the Ready to Apply? Checklist Walkthrough and from the Ready to Apply? Checklist! itself.
Household Composition Worksheet
Information about every member of the household
If a professional helped with the application
- https://www.healthcare.gov/help/whos-helping-me-complete-my-application/
- Understanding the Role of a Health Insurance Advocate
- Get help applying & more | HealthCare.gov
Sources of income for applicant & every member of the household
- What’s included as income | HealthCare.gov
- Publication 17 (2024), Your Federal Income Tax | Internal Revenue Service
Estimating future income
- How to estimate your expected income and count household members | HealthCare.gov
- Income Calculator Tool: Calculate yearly income
- What is MAGI or modified adjusted gross income? | healthinsurance.org
Using income adjustments to determine Adjusted Gross Income (AGI)
Reporting life changes
- Reporting income, household, and other changes | HealthCare.gov
- Which income and household changes to report | HealthCare.gov
- How to report income and household changes to the Marketplace | HealthCare.gov
Worksheet: Other health plan eligibility for every member of the household
About HRAs (Health Reimbursement Arrangement) from employers
- Health Reimbursement Arrangements (HRAs): 3 things to know | HealthCare.gov
- Individual coverage HRAs | HealthCare.gov
- Qualified Small Employer HRAs (QSEHRA) | HealthCare.gov
- Health Reimbursement Arrangements | CMS
Checklist source documents
- Get Ready to Apply for or Re-Enroll in Your Health Insurance Marketplace Coverage
- My Marketplace Application Checklist | CMS
Subsidy & Premium Estimate Calculator Tool
From No SSN? How to Complete Your Marketplace Application (section 2.2 of the OME Guide)
Eligibility based on immigration status/citizenship
- Find out what immigration statuses qualify for coverage in the Marketplace | HealthCare.gov
- Health coverage for lawfully present immigrants | HealthCare.gov
Eligible immigration statuses” for ACA Marketplaces, Medicaid and CHIP
Application assistance resources
- 11658 Getting help in a language other than English
- Helping Families That Include Immigrants Apply for Health Coverage - Beyond the Basics
DACA & the Marketplace
- Federal Register/Vol. 89, No. 90/Wednesday, May 8, 2024/Rules and Regulations
- HHS Final Rule Clarifying the Eligibility of Deferred Action for Childhood Arrivals (DACA)
Marketplace eligibility based on immigration status
- Health Insurance Affordability Programs’ Eligibility Based on Immigration Status - Beyond the Basics
Marketplace subsidies eligibility based on immigration status
- Health Insurance Affordability Programs’ Eligibility Based on Immigration Status - Beyond the Basics
- Yearly Income Guidelines and Thresholds - Beyond the Basics
- Premium Tax Credit - Beyond the Basics
- Cost-Sharing Reductions - Beyond the Basics
More about immigrant eligibility requirements (EXCELLENT RESOURCE)
If ineligible due to immigration-related requirements
- Health Insurance Affordability Programs’ Eligibility Based on Immigration Status - Beyond the Basics
How HealthCare.gov verifies citizenship/immigration status
Immigration status/citizenship documents accepted by the Marketplace
Full list of acceptable citizenship or immigration status documents
- https://www.healthcare.gov/help/immigration-document-types/
- https://www.healthcare.gov/help/how-do-i-resolve-an-inconsistency/#citizenship
- https://www.healthcare.gov/help/how-do-i-resolve-an-inconsistency/#immigration
NOTE! NOT TO BE MISSED!
More information about all of the issues listed above! This guide has everything and walks through examples of different immigration document types that can be used in HealthCare.gov, and notes where different document numbers are located.
Reference Guide to Immigration Documents - Beyond the Basics
Details about ID proofing and the SAVE program
Acceptable documents for ID proofing
Documents to Verify Citizenship
Documents to Verify Immigration Status
- www.healthcare.gov/help/immigration-document-types
- Reference Guide to Documents Used to Verify Immigration Status
Options if you don't qualify for subsidies due to immigration status
- Health Insurance Affordability Programs’ Eligibility Based on Immigration Status - Beyond the Basics
Reference Guide to Immigration Documents
- https://www.healthreformbeyondthebasics.org/wp-content/uploads/2023/09/REFERENCEGUIDE_Immigration-Documents.pdf
- Immigrant-Related Resources - Beyond the Basics
Final note:
Pt. 2.2 is mostly a very condensed version of the incredibly thorough guide provided by Beyond the Basics and readers are encouraged to view their full guides and information. They are a phenomenal resource.
- 3.2 How to Cancel a Marketplace Plan With or Without Replacement (specialty page of the Obamacare? Marketplace? The Exchange?: A Comprehensive Guide e-book from Jensurance)
- How do I cancel my Marketplace plan? | HealthCare.gov
- Find the website for your state-based Marketplace (for states where applicable)
- To determine if you live in a state with federally facilitated or state based Marketplace
- What happens if I want to quit a Marketplace health plan during the year? | KFF
- Cancel your Marketplace plan | HealthCare.gov
DID YOU KNOW: ACA/Marketplace Insurance Myths vs Facts
(from the social media series turned blog by Jennifer Pace at Jensurance)
DID YOU KNOW? Pt 1 of 3: ACA & Marketplace Facts | Jennifer Pace
DID YOU KNOW? Pt 2 of 3: ACA & Marketplace Facts | Jennifer Pace
DID YOU KNOW? Pt 3 of 3: Infographic Gallery | Jennifer Pace
- 2024 Truths and Myths
- About the ACA | HHS.gov
- Data Note: 5 Misconceptions Surrounding the ACA | KFF
- Your total costs for health care: Premium, deductible, and out-of-pocket costs | HealthCare.gov
- Understanding the Affordable Care Act (Obamacare) | eHealth
- Tips about the Health Insurance Marketplace® | HealthCare.gov
- Record Marketplace Coverage in 2024: A Banner Year for Coverage | CEA | The White House
- Getting health coverage outside Open Enrollment | HealthCare.gov
- Health insurance myths debunked: Separating fact from fiction | HealthBird
- Health insurance myths you might have heard | Blue Cross NC
- Who’s included in your household | HealthCare.gov
- Publication 501 (2024), Dependents, Standard Deduction, and Filing Information | Internal Revenue Service
- How to report income and household changes to the Marketplace | HealthCare.gov
Health Insurance Marketplace® is a registered service mark of the U.S. Department of Health & Human Services.