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Individual Health Coverage FAQ’s

Employee Benefits, Personal Lines

Individuals experience a variety of life events throughout the year that fall outside of the individual health open enrollment period, yet affect personal insurance coverage. If you have a change in income, family size, or address, there are additional steps you must take to ensure you have the proper coverage.

M3 Elevate can walk you through reporting changes and submitting proper documentation. Reach out to your M3 Account Executive regarding life changes, documentation proof, and making premium payments. Partnering with experts allows you to streamline these steps and ask questions involving your individual situation.

How do I Report Changes of Income, Family, and Address?

Before updating your application on HealthCare.gov, reach out to your M3 Account Executive to discuss updates to your application. M3 offers platforms to streamline this process.

Application steps

If any of these life events apply, report changes to the Marketplace by updating your application online, by phone, or in-person. Follow the steps below to ensure your application is updated correctly.

  1. Log in to your HealthCare.gov account
  2. Choose the application you would like to update
  3. Click “Report a Life Change” on the left-hand menu
  4. Read through the variety of life changes that apply, and click “Report a Life Change” to get started
  5. Select the life change you want to report on the application
  6. Navigate through the application and report changes to income, household members, address, new health coverage offers, and additional information
  7. After you make adjustments to your application, you’ll get new eligibility results explaining your options to change plans

Reference step-by-step instructions to upload your application online. If you prefer to make updates you your application over the phone, contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325). They are available 24 hours, 7 days a week (excluding holidays). For in-person changes, find a local representative who can assist you.

How do I Submit Additional Proof Documentation?

When submitting your application, the Marketplace may request additional documentation to confirm income, citizenship, immigration status, Special Enrollment Period eligibility, moved locations, or lost health coverage. Uploading the documents online will be the fastest and easiest way to get your application processed, however, you can still elect to send the document proofs via mail. Contact your M3 Account Executive to discuss the uploading process.

Uploading documents online

  • Scan or take a photo of the file and save it to your computer
  • Acceptable formats for online upload:
    • pdf, .jpeg, .jpg, .gif, .xml, .png, .tiff, .bmp
  • Maximum file size:
    • 10MB

Mailing documents

  • Include your printed bar code page (it’s the last page of your eligibility notice)
    • If you don’t have a bar code, include your name and application ID (application ID is found near the top of your notice)
  • Mail documents to the following address

Health Insurance Marketplace, Attn: Coverage Processing
465 Industrial Blvd
London, KY 40750-0001

How do I Pay the Monthly Premium to Complete Enrollment?

If you have Marketplace insurance, you pay premiums to your insurance company – not to the Health Insurance Marketplace. Coverage will not begin until your first premium is paid.

  1. Log in to your Marketplace account
  2. Choose your application under “Your Existing Accounts”
  3. Click the blue button that says, “Pay Your First Health Insurance Monthly Premium”
  4. If online payment is available, select “Pay for Health Plan Now” to go to your insurance company’s website to pay
    Note: some health insurance companies don’t accept online payments. These companies should contact you with next steps

M3 Elevate can provide clients with expert advice regarding any of these steps, from reporting changes on an application to paying monthly premiums. Discuss making your premium payments, submitting proof documentation, or reporting life changes with your M3 Account Executive, or login to your HealthSherpa Dashboard for additional materials.

Key Takeaways

  • Before logging into HealthCare.gov to make changes to your application, reach out to your M3 Account Executive for a potentially streamlined option
  • Be prepared to provide the Marketplace proof of income, citizenship, immigration status, Special Enrollment Period eligibility, location changes, or lost health coverage
  • Discuss paying premiums, proof documents, and making changes to your application with your M3 Account Executive to simplify the process

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