NH Healthcare Exchange: Your Complete Guide

The NH Healthcare Exchange is a vital resource for Granite State residents. It's a marketplace where individuals and families can compare and purchase health insurance plans.

New Hampshire's open enrollment period typically runs from November to January, but you may be eligible for special enrollment periods outside of this timeframe. This is especially true if you experience a qualifying life event, such as losing your job or getting married.

The NH Healthcare Exchange offers a range of health insurance plans from various carriers, including Anthem, Harvard Pilgrim, and MVP Health Care. These plans vary in terms of cost, coverage, and network providers.

Each plan has its own set of benefits and limitations, so it's essential to research and compare them before making a decision.

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New Hampshire's journey to establishing a health insurance exchange was a bit of a rollercoaster ride. In June 2012, former Governor John Lynch signed HB 1297 into law, which prohibited the state from participating in or enabling a state-based health insurance exchange.

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However, this law had a loophole that allowed New Hampshire to operate specific functions of a federally-facilitated exchange. This gave the state a way to still be involved in the process, even if it wasn't fully in charge.

In February 2013, Governor Maggie Hassan confirmed that New Hampshire would pursue a state-federal partnership exchange, which would allow the state to work closely with the federal government to establish the exchange.

On March 7, 2013, New Hampshire received conditional approval from the U.S. Department of Health and Human Services (HHS) to establish a partnership exchange, marking a major milestone in the state's efforts to create a health insurance exchange.

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On the New Hampshire Health Insurance Exchange, you'll find a variety of plan options to suit your needs.

The Exchange offers four "metal" levels of value, which help you compare plans with different levels of coverage for essential health benefits. These levels are categorized as Bronze, Silver, Gold, and Platinum.

You can choose from Bronze plans, which have an actuarial value of 60%, to Platinum plans, which have an actuarial value of 90%.

Here's a quick look at the metal levels offered on the Exchange:

In New Hampshire, you can choose from four metal levels of value on the Health Insurance Exchange, each with a different actuarial value: Bronze (60%), Silver (70%), Gold (80%), and Platinum (90%).

The four metal levels of value are designed to allow consumers to compare plans with different levels of coverage for essential health benefits (EHB).

Bronze plans, for example, pay 40% of the total costs of your healthcare, while Silver plans pay 30% and Gold plans pay 20%.

The Health Insurance Marketplace offers a variety of plans to pick from, including Bronze, Silver, and Gold plans.

These plans pay different amounts of the total costs of your healthcare, as mentioned earlier.

If you're eligible for cost-sharing reductions (CSR), you can select a Silver-level plan to reduce your deductibles and out-of-pocket expenses.

Here are the four metal levels of value, including their corresponding actuarial values:

Short-term coverage can be a lifesaver for those who find themselves without comprehensive health insurance for a short period. In New Hampshire, short-term health plans are available to provide temporary coverage.

Some people may need short-term coverage due to a gap in employment or a temporary move. Short-term health plans can help bridge this gap.

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Enrollment in the New Hampshire healthcare exchange can be done in several ways. You can visit HealthCare.gov, the state's health insurance Marketplace, to compare plans and enroll in the one that best meets your needs.

To enroll in an ACA-compliant individual or family health plan in New Hampshire, the annual open enrollment period is between November 1 and January 15. If you need coverage to start on January 1, you must complete your application by December 15.

You can also enroll outside of the annual open enrollment window if you experience a qualifying life event, such as giving birth or losing other health coverage. Some people can enroll year-round even without a specific qualifying life event.

Financial help is available for consumers on the marketplace. Individuals who purchase insurance through the online health insurance marketplace may be eligible for tax credits based on their monthly health insurance premiums. Consumers at up to 400% of the federal poverty level are eligible for tax credits, and those at up to 138% may have all of their premium costs covered through New Hampshire's expanded Medicaid program.

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Here are the ways to enroll in a New Hampshire Marketplace plan:

You can reach HealthCare.gov’s call center by dialing 1-800-318-2596 (TTY: 1-855-889-4325) for assistance with enrollment.

To qualify for Marketplace health insurance, you'll need to meet some basic requirements. Live in New Hampshire, be lawfully present in the United States, not be incarcerated, and not be enrolled in Medicare.

The majority of Americans qualify to use the Marketplace, but there's a bigger question for most people: financial assistance. To qualify for income-based Advance Premium Tax Credits (APTC) or cost-sharing reductions (CSR), you must meet a few additional parameters.

You can't have access to affordable health coverage through an employer, unless you use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace. You also can't be eligible for Medicaid or CHIP, or premium-free Medicare Part A. If married, you'll need to file a joint tax return. Finally, you can't be able to be claimed by someone else as a tax dependent.

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Beyond those basic parameters, qualifying for Marketplace subsidies depends on your household income. Here are the "essential health benefits" that insurance plans must cover:

New Hampshire has its own set of regulations for health insurance, including a rule that requires insurance networks to include some providers within a certain distance of consumers.

You can enroll in an ACA-compliant individual or family health plan in New Hampshire between November 1 and January 15, which is the annual open enrollment period.

If you need coverage to start on January 1, you must complete your application by December 15. Applications submitted between December 16 and January 15 will have a February 1 coverage effective date.

You can reach HealthCare.gov's call center by dialing 1-800-318-2596 (TTY: 1-855-889-4325) for help with enrollment.

To enroll in an ACA Marketplace plan in New Hampshire, you can visit HealthCare.gov, purchase coverage with the help of an insurance agent or broker, or enroll via an approved enhanced direct enrollment entity.

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You can also get free health insurance navigation services through the NH Navigator Program, which offers assistance with enrollment in the Federal Marketplace, Medicaid, or the Children's Health Insurance Program (CHIP).

To qualify for income-based Advance Premium Tax Credits (APTC) or cost-sharing reductions (CSR), you must not have access to affordable health coverage through an employer, not be eligible for Medicaid or CHIP, and not be eligible for premium-free Medicare Part A.

Here's a summary of the enrollment options in New Hampshire:

New Hampshire residents can find affordable health insurance through the state's reinsurance program, which keeps full-price premiums lower than they would otherwise be. This program took effect in 2021.

If your household income is below 250% of the federal poverty level, you may be eligible for cost-sharing reductions (CSR) to reduce your deductibles and out-of-pocket expenses. As of early 2024, nearly a third of Marketplace enrollees in New Hampshire received CSR benefits.

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To qualify for CSR, you must select a Silver-level plan in the Marketplace. You can also use both premium tax credits (APTC) and CSR benefits if you're eligible for both. APTC can be used with plans at any metal level, but CSR benefits are only available on Silver plans.

Here are some key eligibility levels for financial help:

Dental coverage can be a smart addition to your health coverage, especially if you're hoping to improve your smile.

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Having dental insurance can help prevent costly dental problems by covering routine cleanings, fillings, and other necessary procedures.

Affordable health insurance is a reality in New Hampshire, thanks to the Affordable Care Act (ACA) and other programs.

Subsidies are available to help lower premium payments each month for eligible New Hampshire residents. Nearly three-quarters of New Hampshire Marketplace enrollees received premium subsidies, reducing their health insurance premiums by an average of $352/month.

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If you're not eligible for premium subsidies, the state's reinsurance program keeps full-price premiums lower than they would otherwise be. This program took effect in 2021 and has been a game-changer for many consumers.

Cost-sharing reductions (CSR) are another option for those who select a Silver-level plan and have a household income below 250% of the federal poverty level. Nearly a third of Marketplace enrollees in New Hampshire received CSR benefits, which reduce deductibles and out-of-pocket expenses.

You can use both APTC and CSR benefits if you're eligible for both and select a Silver-level plan in the Marketplace. This can help make health insurance even more affordable for those who need it.

Here's a breakdown of the financial help available to consumers on the marketplace:

New Hampshire has expanded Medicaid eligibility under the ACA, so adults under age 65 are eligible for Medicaid with household incomes up to 138% of the poverty level. This is a great option for those who need comprehensive coverage.

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The New Hampshire Healthcare Exchange has a variety of resources available to help you navigate the process.

The NH Health Plan Marketplace offers a toll-free hotline at 1-855-244-4615, available Monday through Friday from 8am to 6pm EST.

You can also visit the official website of the New Hampshire Insurance Department to get information on licensed health insurance carriers and their plans.

The website also provides a list of certified application counselors who can assist you with the enrollment process.

The NH Health Plan Marketplace website has a comprehensive guide to help you understand the different types of health insurance plans available.

This guide explains the differences between bronze, silver, gold, and platinum plans, as well as catastrophic plans for individuals under 30.

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To sign up for private health coverage through the New Hampshire Marketplace, you must be a resident of the state.

You can sign up for private health coverage through the New Hampshire Marketplace during the annual open enrollment period, which typically runs from November to December.

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In order to sign up for private health coverage through the New Hampshire Marketplace, you must provide proof of residency and identity.

You can also sign up for private health coverage through the New Hampshire Marketplace if you've experienced a qualifying life event, such as losing your job or getting married.

Medicare enrollment in New Hampshire is a crucial aspect of the state's healthcare landscape. Medicare enrollment numbers in New Hampshire are based on effectuated enrollment in early 2024.

You can use a guide to learn about Medicare, Medicare Advantage, and Medigap coverage available in New Hampshire, as well as the state's Medicare supplement (Medigap) regulations. These regulations are important to understand for those looking to enroll in Medicare.

Medicare Advantage has a significant presence in New Hampshire, with many plans available to residents. The state's Medicare supplement (Medigap) regulations are designed to protect consumers and ensure they have access to necessary coverage.

Medicare enrollment in New Hampshire is subject to certain regulations, including those related to Medigap coverage. These regulations are in place to safeguard consumers and promote a fair marketplace.

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The Affordable Care Act's (ACA) implementation was met with uncertainty, particularly at the federal level, where the law's future was constantly debated and threatened.

The Republican-led Congress repeatedly attempted to repeal or replace the ACA, introducing multiple bills aimed at dismantling the law.

In 2017, the House of Representatives passed the American Health Care Act, which would have repealed and replaced the ACA, but it failed to pass in the Senate.

The uncertainty surrounding the ACA's fate created a challenging environment for the New Hampshire healthcare exchange, which had to navigate the changing landscape to ensure continuity of coverage for its enrollees.

The federal government's uncertainty also led to confusion and delays in the exchange's operations, causing frustration for both consumers and insurance companies.

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