ACA Marketplace
Health coverage for individuals and families
ACA Marketplace plans cannot turn you down for a pre-existing condition, and many households qualify for savings. A licensed agent can help you compare what is actually available in your ZIP code.
Timing
When you can enroll
Marketplace enrollment is not open year-round. There are two ways in.
Open Enrollment
November 1, 2026 to January 15, 2027
During this window anyone eligible can enroll or change plans for 2027 coverage, with no qualifying event needed. Enrolling earlier in the window usually means coverage starts sooner.
Some state-run exchanges use different dates. An agent will confirm the window that applies to you.
Special Enrollment Period
Outside Open Enrollment, a qualifying life event can open a limited window, typically 60 days from the event:
- Lost job-based or other qualifying coverage
- Got married or divorced
- Had a baby, adopted, or placed a child in foster care
- Moved to a new ZIP code or county
- Had a change in income that affects eligibility
- Aged off a parent’s plan at 26
Documentation is usually required. Eligibility rules are set by the Marketplace and can change.
Plan tiers
Bronze, Silver, Gold and Platinum
Tiers describe how you and the plan split costs, not the quality of care. Every tier covers the same essential health benefits.
| Tier | Monthly premium | When you use care | Often a fit if… |
|---|---|---|---|
| Bronze | Lowest premium | Highest cost when you use care | Generally healthy, want protection against a major event, rarely see a doctor. |
| Silver | Moderate premium | Moderate cost-sharing | The only tier where cost-sharing reductions apply. Often the best value below 250% FPL. |
| Gold | Higher premium | Lower cost when you use care | Regular prescriptions, ongoing care, or you expect to use coverage often. |
| Platinum | Highest premium | Lowest cost when you use care | Frequent specialist care. Not offered by every carrier in every area. |
Plan availability varies by state and ZIP code. Not every carrier offers every tier in every area.
Savings
How Marketplace savings work
There are two separate programs, and they work differently.
Premium Tax Credit
Lowers your monthly premium. The ACA caps what your household is expected to contribute toward the benchmark Silver plan as a percentage of income; the credit covers the rest. It can be applied in advance each month, so you never see the full premium.
Cost-Sharing Reductions
Lowers your deductible, copays and out-of-pocket maximum, but only on Silver plans, and generally only below 250% of the Federal Poverty Level. This is why a Bronze plan that looks cheaper each month can cost more overall for a lower-income household.
Be careful who you trust on subsidies
Our process
What working with us looks like
- 1
Share your basics
ZIP code, household size, and your situation. Nothing sensitive, and no Social Security number in a web form, ever.
- 2
We confirm your state
Licensing and enrollment paths differ by state. You see your status right away instead of waiting for a callback to find out.
- 3
Compare and decide
A licensed agent reviews verified plans with you. Enrollment happens inside HealthSherpa, a CMS-certified platform, only after you confirm.
Coverage area
Marketplace guidance by state
Select your state for local enrollment details.
Questions
ACA Marketplace FAQ
What is the ACA Marketplace?
The Health Insurance Marketplace was created by the Affordable Care Act so that people without job-based coverage can buy individual and family health plans. Most states use HealthCare.gov; some run their own exchange. All Marketplace plans must cover a set of essential health benefits and cannot deny you or charge more for a pre-existing condition.
What are essential health benefits?
Every ACA Marketplace plan must cover ten categories, including outpatient care, emergency services, hospitalization, maternity and newborn care, mental health and substance use treatment, prescription drugs, rehabilitative services, laboratory services, preventive care, and pediatric services including dental and vision. Adult dental and vision are not included and are usually bought separately.
Can I be denied for a pre-existing condition?
No. ACA Marketplace plans cannot deny coverage, charge you more, or exclude treatment because of a pre-existing condition. Premiums can vary by age, location, tobacco use and plan tier, but not health status.
What if I have coverage through my job?
You can still buy a Marketplace plan, but if your employer offers coverage that the law considers affordable and adequate, you generally will not qualify for a premium tax credit. An agent can walk through how that test works for your situation.
What does an agent cost me?
Nothing. Licensed agents are compensated by the carrier when someone enrolls. The premium is the same whether you use an agent or enroll yourself. The difference is having someone compare plans, check whether your doctors are in network, and handle the paperwork.
What is a benchmark plan?
The second-lowest-cost Silver plan available in your area. It is the reference point used to calculate premium tax credits. You do not have to buy the benchmark plan. It is simply the yardstick the subsidy math uses.
Ready to see your options?
Answer a few quick questions and a licensed agent will review what is available in your state. Free, and no obligation to enroll.
My Health Enrollment is a private insurance agency. We are not affiliated with, endorsed by, or acting on behalf of any government agency, including the Centers for Medicare & Medicaid Services (CMS) or Healthcare.gov.