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Health Insurance Marketplace


Health Insurance Marketplace
What you need to know

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Do I need health insurance?

What is the Health Insurance Marketplace?

The Health Insurance Marketplace is a new way to find health insurance. Health insurance pays part of medical costs when someone is sick or hurt. 

What's covered in the Health Insurance Marketplace?

Every health insurance plan sold in the Marketplace will offer 10 essential health benefits.  

Who should enroll?

Many legal residents of Pennsylvania who don’t have health insurance can buy it on the Health Insurance Marketplace. If you have job-based health insurance, you can keep it. If you qualify for Medicaid, you are not eligible to buy a plan on the marketplace. Everyone is required by law to have health insurance in 2014.

When can I enroll?

Open enrollment on the Health Insurance Marketplace ended on March 31, 2014.  The next enrollment is November 15, 2014-February 15, 2015.

What will I need to enroll?

Be prepared. You will need the Social Security Number (or legal immigrant document number) for each family member you want to enroll. You will need the name of the employer, income information and health insurance.

How do I enroll?

Please click on one of the links below to follow the enrollment process:

Do you know the important dates?

  • December 15, 2014: The last date to enroll for coverage that starts January 1, 2015
  • December 31, 2014: Date when all 2014 Marketplace coverage ends, no matter when you enrolled
  • January 1, 2015: The date 2015 coverage can start if you apply by December 15, 2014, or if you accept automatic enrollment in your 2014 plan or a similar plan

How hard is it to apply online?

It is easy to apply online. You need to have an email account, or you can create one at no cost. Each step is explained you move from screen to screen as you complete information. The is a Live Chat feature (blue box) on each screen if you need help. You can call 1-800- 318-2596 while you are online for help as well.

How much will it cost?

Your cost will depend on your personal situation. Some people may qualify for lower cost insurance.

What happens if I don’t do anything?

  • If you do not plan to file a tax return you do not need to do anything. Your income is probably below the standard for the federal poverty level.
  • If you are have insurance through a parent, spouse, job, the military, the government (like Medicaid or Medicare), or other special reasons you do not have to do anything.
  • If you are uninsured and you make no effort to obtain health insurance you may be subject to a penalty of $ 95 or 1% of income per adult ($47.50 per child) in 2014.
  • IN 2015 it increases to $325 per adult ($162.50 per child) or 2% of income with a maximum of $975 per family and in 2016 it will be $695 per adult  ($347.50 per child)or 2.5% of income with a maximum of $2,085 per family.  Successive years will see the penalty increase at a rate indexed to inflation.
  • Keep in mind that if you are uninsured, you only owe a penalty for the months you are without coverage after a three-month period, and the fee is pro-rated.
  • If you do owe a penalty, it will be withheld from your 2014 tax refund. If the payment is not made, the IRS can withhold the amount from any future tax refunds, with an accrued interest of approximately 3 percent.
  • However, the IRS cannot impose liens, levies or criminal penalties for failure to pay the penalty.

Still need help? has a new department for people who have a Change In Circumstances (CIC). Call 1-800-318-2596 and confirm identity, explain that you have a CIC and they will transfer you to that department as needed. You  no longer need to delete a previous application and start over to amend with new information caused by a change in circumstances.