ACA Marketplace Health Insurance

We do all the work, at no cost to you. Ever.

Compare plans available in your area
See if you qualify for subsidies and rewards programs
Pre-existing conditions are covered
Help with Open Enrollment and life changes

Your information is private and secure. Privacy Notice

5 quick steps, about four minutes.

Do you have Medicaid right now? *

Yes No

Please choose Yes or No

If you have Medicaid, do not complete this form. Having Medicaid and Marketplace savings at the same time is not allowed. If a family member without Medicaid needs coverage, you can continue for them.

Enter your own information below. You'll add your family member on the next step.

First Name *

Please enter your first name

Last Name *

Please enter your last name

Email *

Please enter a valid email

Mobile Phone *

Please enter a valid phone number

ZIP Code *

Please enter a valid 5-digit ZIP code

State *

Please choose your state

You and Your Household

About You

Date of Birth *

Please enter a valid date of birth (MM/DD/YYYY)

Sex *

Female Male

Please choose one

Are you applying for health coverage? *

Yes No

Choose No if you're only applying for your children or other family members.

Please choose Yes or No

Are you a U.S. citizen or U.S. national? *

Yes No

Please choose Yes or No

Have you used tobacco 4 or more times a week, on average, in the last 6 months? *

Yes No

Don't count tobacco used only for religious or ceremonial purposes.

Please choose Yes or No

How will you file your federal taxes? *

Please choose one

Your Household

Add anyone you'll claim as a dependent on your taxes, even if they don't need coverage.

At least one person needs to be applying for coverage.

Does anyone applying for coverage currently have health insurance? *

Yes No

Please choose Yes or No

Address & Income

Your address and income help us find the plans and savings you qualify for.

Home Address

Street Address *

Please enter your street address

Apt / Suite (optional)

City *

Please enter your city

State *

Please choose your state

ZIP Code *

Please enter a valid 5-digit ZIP code

My mailing address is different

Estimated Income for

Tell us how much each person is likely to earn in . A best estimate is fine.

Estimated household incomeBased on the amounts you entered above.

$0

At least one person in your household needs to have income to qualify for Marketplace savings.

Social Security Number

This is a mandatory step for the Marketplace to determine eligibility.

It's encrypted and only used for your Marketplace application.

Each person needs their own Social Security number. Please check for duplicates.

Your Permission

Marketplace rules require your permission before we can help with your application or use your information.

Type your full name to sign *

Please type your full name to sign

Can we message you about your application by text or WhatsApp? *

Yes No

Please choose Yes or No

✓

Thank You

We received your information. A licensed agent from Curl Insurance Services will review it and reach out within 1 business day.

We'll follow up with you at .