Use this checklist to get ready before you talk with our licensed agent. We'll help you answer three questions: Can you enroll in a Marketplace plan? Can you get financial help? Can you enroll now? The Marketplace makes the final eligibility decision.
1. Who needs coverage
- Have your name, phone number, state of residence, ZIP code, and the date you'd like coverage to start.
- List everyone who needs coverage and their ages. Also list other people in your household who belong on the application, even if they already have coverage or aren't applying.
- Tell us about any current coverage through work, Medicaid, CHIP, Medicare, or the Marketplace, and when it ends.
- If it's outside open enrollment, tell us about any recent life event, such as losing coverage, marriage, a birth, an adoption, or a move. Note the event and its exact date so our agent can check whether you can enroll now.
- Applications go through your state's official Marketplace: Virginia's Insurance Marketplace or Maryland Health Connection.
2. Citizenship or immigration status
| If you are… | What it means for you |
|---|---|
| A U.S. citizen or U.S. national | You can continue with enrollment and check for financial help. |
| A green card holder, Cuban/Haitian entrant, or Compact of Free Association (COFA) migrant | You may qualify for federal Marketplace financial help in 2027 if you meet the other requirements. |
| Holding a work permit, asylum, refugee status, TPS, parole, or a pending application | Tell us the immigration status your document is based on, and our licensed agent will review your options. A work permit alone doesn't make you eligible for financial help, but you may be able to buy a full-price plan. |
| In a household where members have different statuses | Each person applying is checked separately. Family members who aren't applying may still need to be listed for household size and income, but they don't have to share their immigration status. |
| Unsure of your status, or your documents don't match | Our licensed agent will review your situation. We'll give you a secure way to share any documents. |
These categories apply to federal premium tax credits and cost-sharing reductions starting January 1, 2027. Your state Marketplace will tell you about any separate state help or coverage options. www.cms.gov
3. Your 2027 tax household
Think about: "How will I file my 2027 federal tax return, and whom will I claim as dependents?"
- Know your expected filing status and who will be on your return: you, your spouse if applicable, and your dependents. Let us know if someone else might claim anyone applying.
- If you're married, plan to file jointly. Filing separately usually means you can't get federal premium tax credits. If you're separated or have experienced domestic abuse or abandonment, tell us privately and we'll review your options.
- Tell us about shared custody, uncertain dependent claims, or if you don't plan to file a federal return.
- If you got advance Marketplace credits before, have you filed your taxes and reconciled them using Form 1095-A and Form 8962? Let us know about missing returns or IRS notices.
- If you take advance credits in 2027, you must file a federal return and reconcile them. If you receive too much in advance credits, you may have to pay it all back. www.irs.gov
4. Your income and the household-size table
Think about: "What will my household earn from January through December 2027, and what are we earning per month right now?"
- Wages: Your expected taxable wages, including tips, overtime, and bonuses.
- Self-employment and gig work: Your net profit after business expenses. If you drive for Uber or Lyft or deliver for DoorDash, have your total earnings and expenses ready separately.
- Other income: Unemployment, Social Security, pensions, retirement withdrawals, rental profit, interest, dividends, capital gains, and foreign income.
- What counts: Tax-exempt interest, nontaxable Social Security, and excluded foreign income can count. SSI usually doesn't. A dependent's income usually counts only if they must file a federal return.
- Have both your current monthly income and your expected 2027 yearly household income. If your income changes during the year, let us know. www.irs.gov
| Household size | Approximate adult Medicaid limit — Marketplace financial help usually starts above this amount | Federal Marketplace premium tax credit income limit |
|---|---|---|
| 1 | $22,025 | $63,840 |
| 2 | $29,863 | $86,560 |
| 3 | $37,702 | $109,280 |
| 4 | $45,540 | $132,000 |
| 5 | $53,378 | $154,720 |
| 6 | $61,217 | $177,440 |
| 7 | $69,055 | $200,160 |
| 8 | $76,894 | $222,880 |
Reading the table: The middle column is 138% of the 2026 federal poverty guidelines on a yearly basis, rounded to the nearest dollar. It's a guide for adults ages 19–64. Medicaid may look at your current monthly income, and its limits can change during 2027. The right column is 400% of the federal poverty level used for 2027 Marketplace coverage. Being within these ranges doesn't guarantee a credit. aspe.hhs.gov
- At or below the Medicaid limit: You may qualify for Medicaid first. For example, a single adult earning a steady $20,000 a year in Virginia or Maryland would usually be checked for Medicaid first.
- Between the two limits: You may qualify for Marketplace financial help, depending on the other factors.
- Above the federal limit: You can still buy a full-price Marketplace plan, and we'll check for any separate state help.
- Close to a limit, income that varies, or denied Medicaid for a reason other than income: Our licensed agent will review your situation. Children and pregnant applicants may qualify under different Medicaid or CHIP limits. coverva.dmas.virginia.gov
5. Other coverage you may be offered
- Tell us if anyone applying has been offered coverage through a job, even if they turned it down.
- Have the cost and pay schedule for the lowest-cost employee-only plan and, if family members need coverage, the cost to add them. Ask the employer whether the plan provides minimum value. You and your family members may get different results.
- Tell us if your employer offers a reimbursement arrangement such as an ICHRA or QSEHRA, or if anyone may qualify for Medicare, Medicaid, or CHIP.
- If the Marketplace approves you for cost-sharing reductions, our licensed agent will compare Silver plans with lower deductibles and copays. www.irs.gov
6. Next steps
- We'll tell you where your case stands: ready for agent review, Medicaid/CHIP check, full-price plan review, missing information, or enrollment window review.
- If anything is missing, we'll tell you what we need and when. Please send tax records, immigration documents, and Social Security numbers only through our secure upload process.
- Before anything is submitted, our licensed agent will review the application with you and get your authorization as the Marketplace requires.
- After you enroll, confirm your plan, start date, monthly premium, first payment instructions, and any verification deadlines.
Our promise: We'll check whether you qualify for Medicaid or a Marketplace plan and whether financial help is available. We'll confirm the exact amount once the Marketplace processes your application.