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 all but 12 states* and the District of Columbia, the marketplace is run by the federal government through www.HealthCare.gov. In states that operate their own marketplace, it may have a different name, such as Covered California, Kynect, Washington Healthplanfinder, or New York State of Health. All marketplaces are open for enrollment from November 1, 2016 to January 31, 2017, and you may be able to get coverage during other times of the year if you get married, have a child, lose a job, or have another major life event.

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

  • November 1, 2016: Open enrollment starts. This is the first day you can enroll in a 2016 insurance plan through the Health Insurance Marketplace.
  • January 1, 2017: Coverage starts for those who enroll or change plans by December 15.
  • January 31, 2017: Open enrollment ends. This is the last day to enroll to avoid a penalty for not having health insurance.

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