What information do you need to enroll?

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So. You’ve decided you’re going to apply…

No matter if you’re on the national exchanges or if your state has their own exchange - you’ll need the same information to apply for health insurance. So what do you need?


  • Your most recent tax return - likely from tax year 2016.*

*You’ll need the information from here to help with a number of the questions you’ll come across on your application.
 

  • Your home address and/or mailing address

You CANNOT list a P.O. Box as your home address BUT you CAN list a P.O. Box as your mailing address.

 

  • Information on EVERYONE in your household

Who does that include? Glad you asked! EVERYONE. (Nearly - according to this full list of relationships provided by healthcare.gov)

You

Your spouse or unmarried partner*

(If they’re the parent of your child(ren) and/or you list them as a dependent on your taxes)

Your child dependents who live with you (even if they file a tax return themselves)

Any dependent listed on your tax return (even if they DONT live with you)

Anyone under 21 years old who lives with you that you take care of

You can find more detailed information on households and household size here.

 

  • Health insurance information for anyone in your household that currently has coverage.

This includes VA Health Care, Medicare, TRICARE, Child Health Insurance Program coverage, and Medicaid. You’ll need their policy ID numbers (found on their cards OR on insurance plan documents such as an EOB). If you don’t have either of these, you might have to call the insurance provider and ask for their policy information.

 

  • Employer information for EVERYONE in your household.

You’ll need to answer questions about employer health coverage offered (or not) by the employers of EVERYONE in your household. If you can get coverage through your employer or a family member’s employer, you’ll need to enter that here. You’ll also need to enter the employer name and contact information for those in your household who are employed…

Which leads us to our next bit of documentation you’ll need to complete IF anyone in your household has or is eligible for health insurance through their employer you’ll need....

 

  • A completed “Employer Coverage Tool” for each person who is eligible for employer provided health coverage

EVEN IF those who are eligible are not enrolled through their employer health coverage and/or aren’t applying through the Marketplace for health insurance. That resource is available here - make sure to fill one out for each person eligible for health coverage through an employer plan, even if it’s from a spouse or parent’s job.   

 

  • How you (and those in your household) will file your taxes

What does that even mean? Well! On many other “Here’s what you need to apply for health insurance” lists - this is listed further down this list with little to no explanation - just links. That’s not helpful, especially if you get all the way into that application and you realize your 19 year old with a full time job who you can’t claim as a dependent needs to fill out their own application for health insurance.

This piece of information and the application is specifically to determine WHO, if anyone, in your household will need to apply for health insurance separately from you.

For example - If you (and if applicable, your spouse) claim your child(ren) on your taxes as dependents EVEN IF they file their own tax return - that child(ren) will be on YOUR application for health insurance in the exchange AND will be on the same plan as you.

ANYONE you claim as a dependent on your taxes (even if it’s your own parent) could be on your application for coverage and would be on the same plan as you.

If you DON’T claim your child as a dependent AND they file their own taxes - that child will need to file for their OWN health insurance through the exchange and WILL NOT be on your plan.

If you’re married - things get a little bit interesting after this… and very… tax like. There is no way to reasonably break this part down in a primer - so it’s best to just head over here to this portion of the healthcare.gov site and read through it. If you’re not sure exactly what’s going on (you’re not alone), don’t be embarrassed - call 1-800-318-2596 (1-855-889-4325 for TTY) OR check here to see if there are local navigators that can help you out.

Please note - if you are still legally married but a victim of spousal abandonment (cannot find your spouse after making reasonable attempts to find them) and/or a victim of domestic abuse - you CAN select “No” when asked if you are married. Verbatim from the healthcare.gov site:

“If you’re living apart from your spouse and are a victim of domestic abuse, domestic violence, or spousal abandonment and want to enroll in your own health plan separate from you abuser or abandoner, you can say you’re “unmarried” on your Marketplace application without fear of penalty for mis-stating your marital status.

This will let you (and possibly your dependents) qualify for premium tax credits and other savings based on your income.”

 

  • Your social security number and the social security numbers of everyone in your household

Even those not applying for coverage

You can find more information here about SSN’s and your application. It’s important to note that if you’ve changed your name BUT it hasn’t been changed on your social security card yet - that you will need to enter the name - EXACTLY as it appears on your social security card.

 

  • Employment & income information for EVERYONE in your household

Depending on your circumstances, you might be asked about income, deductions, and expenses of EVERYONE in your household - again - even those who are NOT applying for coverage. The kinds of income that you must disclose include wages, unemployment income, social security payments, rental income… essentially any kind of taxable income EXCEPT Supplemental Security Income aka: SSI.

Once again healthcare.gov comes through with the list of income to include here.

 

  • Your best estimate for your household income in 2018.

Do your best to make an estimate. You can find information and help on making this estimate here. A good estimate starts with your Adjusted Gross Income from the taxes you most recently filed (likely tax year 2016). From there use the link above to move right along...

 

  • Immigrant Documentation Information

There’s a lot of work to be done to expand who is covered in this category. Unfortunately, only those who are “lawfully present” immigrants are eligible to apply for coverage through the insurance marketplace. To find out more about what the government defines this as and to read about the information you’ll need to apply on the Marketplace if you’re eligible - click on through.

 


We hope this was helpful! Now we need your help! We want to know what YOU want to know! Send us your questions!

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This is the part where you ask the questions that are keeping you up late at night... Like can you cover your pet because they are your child?
Tanith Broom