Key Dates and Facts About the New Healthcare Plans

Since January 2014, almost everyone in the United States has to have health insurance coverage for themselves and their families. If you don't have coverage or want to get new coverage, you can shop online, over the phone, or in person in your state's health insurance marketplace (sometimes called an "exchange") for a plan that fits your needs. If it's hard for you to afford insurance, you might be able to get financial help to purchase coverage.

In most states, the marketplace is run by the fed­eral government through www.HealthCare.gov and will be open for enrollment from November 1, 2017 to December 15, 2017. If you miss this period, you may be able to get coverage during other times of the year but only because of major life changes (like getting married, having a child, losing a job, or having another major life event). About 11 states* and the District of Columbia operate their own marketplaces. In these states, the marketplace may have a different name, such as Covered California, Kynect, Washington Healthplanfinder, or New York State of Health, and be open for different dates. For instance, Covered California will be open until January 31, 2018. It is best to check with your state's market­place for additional information.

Three key dates you'll want to mark on your calendar:

  • November 1, 2017: Marketplaces open for enrollment for coverage to start on January 1, 2018.
  • December 15, 2017: Open enrollment ends. This is the last day to enroll to avoid a penalty for not having health insurance.
  • January 1, 2018: New coverage begins.

Health reform includes extensive new nondiscrimination protections for LGBT people. Nobody who works with the marketplaces, including employees, insurance companies, and people helping you look for coverage, can discriminate based on sexual orientation or gender identity. Insurers can't offer plans with benefits that discriminate based on sexual orientation, gender identity, sex, or health condition. No one can be denied coverage or charged more because of a pre-existing health condition. And if you're legally married to someone of the same sex, you have the right to the same family coverage options through the marketplace as any other married couple, regardless of what state you live in.

Every insurance plan sold through the marketplaces will have to cover a core set of basic benefits called "essential health benefits." These benefits include a variety of services and medical procedures such as doctor visits, hospital stays, preventive screenings, prescription drugs, laboratory services, maternal and newborn health care, and mental and behavioral health services.

To help you compare them, all health plans in the marketplace have a metal level: bronze, silver, gold, or platinum. These levels describe the level of coverage in each plan. If you buy a bronze plan, your plan will cover about 60 percent of your healthcare costs, and you will have to pay about 40 percent of your healthcare costs yourself in charges such as deductibles, co-pays, and co-insurance. If you buy a silver, gold, or platinum plan, the percentage that you have to pay for your healthcare costs decreases. Different insurers in your state's marketplace offer a variety of plans in different metal levels. Picking the right metal level of insurance for you and your family is a critical first step in comparing plans.

* The 11 states with state- run insurance marketplaces are: CA, CO, CT, ID, MD, MA, MN, NY, RI, VT, and WA