ACA Marketplace FAQs

Most U.S. citizens and lawfully present immigrants are eligible for ACA coverage. Income level, family size and state of residence all play a role in what plans and savings you may be eligible for.

In Michigan, the Open Enrollment Period runs from Nov. 1 to Jan. 15. You can shop plans and see prices during October, but you can't enroll until Nov. 1.

• If you enroll between Nov. 1 and Dec. 15, your coverage will start Jan. 1
• If you enroll between Dec. 16 and Jan. 15, your coverage will start Feb. 1

If you miss the annual Open Enrollment Period (OEP), you may qualify for a Special Enrollment Period (SEP) due to life events like losing coverage, moving or having a baby. If you don't have a qualifying life event, you'll have to wait until OEP.

You can apply online at healthcare.gov, through an agent or broker, by phone, in person, or directly through a participating Marketplace provider like Priority Health.

Use the plan comparison tool on healthcare.gov or the website of a participating Marketplace provider, such as Priority Health.

Compare:

• Monthly premium: What you pay each month to have health insurance, regardless of whether you use any medical services
• Deductible: What you pay out of pocket before your health insurance starts covering costs
• Out-of-pocket costs: What you pay when you receive care, like copays and coinsurance
• Out-of-pocket maximum: The most you'll pay in a year for covered services
• Covered services: Medical treatments your health insurance plan agrees to pay for, fully or partially
• Provider networks: A group of health care providers that work with your insurance company at discounted rates

Metal tiers reflect how you and your plan share costs, not the quality of care.

• Bronze generally means lower monthly premiums but higher out-of-pocket costs when you receive care.
• Silver generally means moderate monthly premiums and moderate out-of-pocket costs when you receive care.
• Gold generally means higher monthly premiums but lower out-of-pocket costs when you receive care.

You can only switch your Marketplace plan if you qualify for a Special Enrollment Period or during the annual Open Enrollment Period.

If you qualify for subsidies, financial help is available in the form of:

• Premium tax credits to lower monthly costs
• Cost-sharing reductions to lower deductibles and copays

Learn more about how to save on health coverage.

For 2025, federal subsidies are available for most people earning up to 400% of the federal poverty level - and sometimes beyond, depending on your situation.

When you get a quote for a MyPriority plan, we'll check to see if you qualify for financial assistance.

To reconcile your tax credit:

1. Get your Form 1095-A, also known as the Health Insurance Marketplace Statement. You will receive it in the mail or retrieve it from your healthcare.gov account.
2. Print Form 8962 and instructions
3. Use the information from your 1095-A form to complete Part II of Form 8962
4. Submit Form 8962 with your tax return

Full instructions are available on healthcare.gov.

To update your information:

1. Log in to your account at healthcare.gov.
2. Go to your application or dashboard.
3. Select “Report a Life Change” or “Update Application”.
4. Enter your updated income, household size, or other relevant details.
5. Review and submit your changes to make sure your coverage and savings stay accurate.

Keeping your info up to date helps avoid incorrect subsidies or unexpected costs.

Update your Marketplace application yearly to confirm eligibility, financial subsidies and avoid surprises.