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Individual Health Insurance

Individual Insurance Options for People With Multiple Sclerosis

Choosing Individual Healthcare

  • special enrollment due to circumstances such as moving out of state, getting married or having a baby.You can enroll in coverage through:
    • The Marketplace at HealthCare.gov or 800-318-2596. In some communities, information and enrollment help is available at certain hospitals, clinics, pharmacies or community service organizations. Read more about the Marketplace below or explore options close to you by using the Find Local Help option at HealthCare.gov.
    • State exchanges in select states.
    • Insurance companies that offer individual health insurance.
    • An insurance agent or broker licensed by your state.
    An important note: Tax credits that help make individual coverage more affordable for individuals and families are NOT available when you enroll in coverage directly through an insurance company, agent or broker.Watch Ask an MS Expert: Get Ready for Open Enrollment. In this webinar, National MS Society MS Navigator Nicole Vasquez helps you navigate the open enrollment period." c-nmssatomrichtext_nmssatomrichtext-host="">
    Most people who choose an individual health insurance plan enroll during the open enrollment period that starts Nov. 1. To have your coverage in place by Jan. 1, you must enroll by Dec. 15.There are exceptions for those who qualify for special enrollment due to circumstances such as moving out of state, getting married or having a baby.You can enroll in coverage through:
    • The Marketplace at HealthCare.gov or 800-318-2596. In some communities, information and enrollment help is available at certain hospitals, clinics, pharmacies or community service organizations. Read more about the Marketplace below or explore options close to you by using the Find Local Help option at HealthCare.gov.
    • State exchanges in select states.
    • Insurance companies that offer individual health insurance.
    • An insurance agent or broker licensed by your state.
    An important note: Tax credits that help make individual coverage more affordable for individuals and families are NOT available when you enroll in coverage directly through an insurance company, agent or broker.Watch Ask an MS Expert: Get Ready for Open Enrollment. In this webinar, National MS Society MS Navigator Nicole Vasquez helps you navigate the open enrollment period.

  • Extra savings are available for people with household income between 100% and 250% of the federal poverty level, or $14,580 for a household of one in 2023. You MUST enroll in a Silver level plan to qualify for extra savings.
If coverage is unaffordable for you, find out if you qualify for a hardship exemption." c-nmssatomrichtext_nmssatomrichtext-host="">
Many factors determine the cost of individual healthcare plans including:
  • Premiums vary significantly depending on location, coverage, age and whether you use tobacco.
  • All individual insurance plans sold through the Marketplace or state exchanges are available on an income scale. Applicants in households with income below 400% of the federal poverty level ($30,000 for a family of four in 2023) receive tax credits that are applied immediately so their monthly premiums are more affordable.
  • Plans are listed as Platinum, Gold, Silver or Bronze depending on coverage. Platinum plans cover the most. Bronze plans cover the least.
  • Extra savings are available for people with household income between 100% and 250% of the federal poverty level, or $14,580 for a household of one in 2023. You MUST enroll in a Silver level plan to qualify for extra savings.
If coverage is unaffordable for you, find out if you qualify for a hardship exemption.

  • 10 essential health benefits. This includes policies sold in the Marketplace or directly through an insurer outside of the Marketplace. All health insurance including Medicare and Medicaid plans must cover recommended preventive health services (such as cancer screenings and vaccines) at no additional cost to you when you receive them from a provider in your plan’s network." c-nmssatomrichtext_nmssatomrichtext-host="">
    By law, most individual policies must cover 10 essential health benefits. This includes policies sold in the Marketplace or directly through an insurer outside of the Marketplace. All health insurance including Medicare and Medicaid plans must cover recommended preventive health services (such as cancer screenings and vaccines) at no additional cost to you when you receive them from a provider in your plan’s network.

  • You may have to do extra research to find out if your doctor, hospital or specific medications are covered by any of the individual plans you are considering. These and other details should be available through your state’s online Marketplace or the insurance company.

  • Healthcare.gov.If you choose an individual plan through the Health Insurance Marketplace and enroll in Medicaid and CHIP, you must re-certify for continued coverage every year. Each state has its own process for recertifying enrollees in these programs. Watch for notices from your Medicaid or CHIP plan and follow the procedures carefully." c-nmssatomrichtext_nmssatomrichtext-host="">
    Individuals or families with children but no health insurance can explore their eligibility for Medicaid or the Child Health Insurance Program (CHIP) for children under age 19 at any time. There is no open enrollment period for Medicaid or CHIP. You can learn about and apply for these government-sponsored health insurance programs at Healthcare.gov.If you choose an individual plan through the Health Insurance Marketplace and enroll in Medicaid and CHIP, you must re-certify for continued coverage every year. Each state has its own process for recertifying enrollees in these programs. Watch for notices from your Medicaid or CHIP plan and follow the procedures carefully.

    • Health Insurance Marketplace

    Health Insurance Terms

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    © 2025 The National Multiple Sclerosis Society is a tax exempt 501(c)3 nonprofit organization. Its Identification Number (EIN) is 13-5661935.

    The National Multiple Sclerosis Society is proud to be a source of information on multiple sclerosis related topics. Unless otherwise indicated, the information provided is based on professional advice, published experience and expert opinion. However, the information does not constitute medical or legal advice. For specific medical advice, consult a qualified physician. For specific legal advice, consult a qualified attorney.