What documents do I need to apply for Marketplace insurance?
A checklist to gather before you start, plus the document requests that arrive after you enroll and cancel coverage when people ignore them.
The application takes about half an hour if everything is in front of you and considerably longer if it is not. Here is the list.
For everyone in the household
- Full legal names as they appear on tax returns
- Dates of birth
- Social Security numbers for anyone who has one
- Home address and mailing address if different
Include everyone on your tax return, even people who will not be on the plan. Household size changes the subsidy calculation.
Immigration documents, if applicable
- Permanent resident card, and the card number
- Employment authorization document
- Visa and passport information
- Notice of action for a pending application
- Any document showing lawfully present status
See who qualifies.
Income
- Recent pay stubs, or an employer letter
- Last year's tax return as a reference point
- Profit and loss records if you are self employed, since the figure used is income net of business expenses
- Unemployment benefit statements
- Social Security benefit statements, including the untaxed portion
- Records of rental, interest, dividend or retirement income
You are estimating the coming year, not reporting last year. See how self employed income works.
Employer coverage information
If anyone in the household has an offer of job based coverage, the Marketplace asks about it in detail. Get the employer to complete the coverage tool worksheet, or at minimum get:
- Employer name and contact information
- Whether coverage is offered and to whom
- The premium for the lowest cost employee only plan that meets minimum value
- Whether the plan meets minimum value
An available affordable offer generally disqualifies you from a subsidy, so answer accurately.
For choosing the plan afterward
- Your doctors' names and the hospital you would use
- A current medication list with dosages
- Your pharmacy
The part that catches people out
After you enroll, the Marketplace often sends a request for documents to verify income, identity, citizenship or immigration status. These arrive by mail and in your Marketplace account, and they have hard deadlines. Missing one can end your coverage or your subsidy. This is the most common reason people who did everything else right lose coverage.
Check your Marketplace inbox and your physical mail through the first few months. Upload documents as soon as they are requested rather than close to the deadline, since documents sometimes need to be resubmitted.
Also watch for Form 1095-A in January. You need it to file your taxes and reconcile the credit. See how the credit is reconciled and the application walkthrough.
Common follow-up questions
Do I need a Social Security number?
You provide one for anyone who has one. Some lawfully present immigrants do not have one and can still apply using their immigration document numbers.
What if I cannot estimate my income?
Give the most realistic figure you can and update the Marketplace when it changes. Self employed applicants especially should revisit it during the year.
What happens if I miss a document deadline?
Coverage or the subsidy can be terminated. Contact the Marketplace immediately, because it is sometimes recoverable if you act quickly.
Want this looked at properly?
We are an independent agency in McAllen serving Hidalgo, Cameron and Starr counties. No cost to talk it through.
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