More than 16 million people obtained coverage through the exchanges nationwide during the open enrollment period for 2023 coverage.
People who areeligible for Medicaid based on their incomecan enroll in Medicaid via the exchange in their state.
It’s “exchanges,” plural, because each state has an exchange.
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Virginia will begin operating its own exchange platform in November 2023.
But the term “market” is used more generally.
What’s the Difference Between “On-Exchange” and “Off-Exchange”?
An “on-exchange” plan is simply one that’s purchased through the exchange.
And some states require on-exchange plans to embed pediatric dental coverage on each health plan.
The rest of the excepted benefits are designed to serve as supplemental coverage.
Excepted benefits and “non-insurance” plans are available off-exchange in most areas.
Dental/vision plans are available on-exchange in most areas.
Who Can Use the Exchanges?
Under ACA rules, undocumented immigrants cannot enroll in coverage through the exchanges, even withoutpremium subsidies.
And Colorado has created a separate platform that undocumented immigrants can use to obtain coverage.
How Many People Have Coverage Through the ACA’s Exchanges?
This direct competition is meant to keep the cost of health insurancepremiumsdown.
Standardized plans are available in the exchanges in nearly all states, including those that use HealthCare.gov.
In California’s exchange, all of the plans are standardized.
Everything else applies to the deductible and is only covered after it’s met.
Learn more about health insurance subsidies in, “Can I Get Help Paying for Health Insurance?”
But you might’t do that if you bought your plan off-exchange.
But to take advantage of that extra financial help, you must be enrolled in an on-exchange health plan.
In that case, residents use the federal government’s exchange at HealthCare.gov.
), it’s in your best interest to comparison shop in your state’s exchange.
Centers for Medicare and Medicaid Services.Entities approved to use enhanced direct enrollment.
Centers for Medicare and Medicaid Services.2023 marketplace open enrollment period public use files.
U.S. Centers for Medicare & Medicaid Services.Overview of SHOP: Health insurance for small businesses.
healthinsurance.org.Can small businesses use the ACAs health insurance marketplaces (exchanges)?
Healthinsurance.org.What key in of exchange does my state have?
Covered California.Health insurance through Covered California.
HealthInsurance.org.ACA open enrollment 2025 guide.
healthinsurance.org.Washington, D.C. health insurance consumer guide.
U.S. Department of Labor, Employee Benefits Security Administration.Health benefits coverage under federal law.
HealthInsurance.org.The scoop: April 1, 2020 edition.
HealthInsurance.org.How immigrants can obtain health coverage.
Centers for Medicare and Medicaid Services.Market rating reforms.
DC City Council.FY19-20 HBX Performance Oversight Hearing: Q1_Attachment A Schedule A as of Jan. 5, 2021.
DC Health Link.Congressional Enrollment.
ACA Signups.Breaking: CMS retools federal shop program…And a nation yawns.
U.S. Centers for Medicare & Medicaid Services.Information on essential health benefits (EHB) Benchmark plans.
