Step by Step: How to Sign up for Health Insurance in the New Exchanges

BRADENTON – People can now enroll in health care coverage through insurance exchanges created by the Affordable Care Act. The enrollment window to sign up began Tuesday and ends Sunday, December 15, for policies that begin coverage, January 1, 2014. However, knowledge of how to access the exchanges still polls very low. Here's an easy guide.

Regardless of your state, all Americans can start at healthcare.gov, the federal online Affordable Care Act portal. There, they will be asked to enter the state where they reside.

If you live in a state that's running its own exchange, you will be directed there, or you can just go directly to your state's exchange website. Those in the states where the federal government is running the exchange (including Florida) will apply through the federal portal, which is accessed from the website.

They will then set up an account and provide information, such as name, address, age, number of people in their family, household income, employer and whether you have access to insurance anywhere else. Applicants also have to say whether they smoke, since insurance carriers can charge tobacco users more (the only exception to pre-existing conditions and lifestyle indicators).

Applicants can apply for a federal subsidy, which may require them to provide pay stubs and tax information if the income they enter doesn't match IRS records. Enrollees will get and instant response as to whether they qualify for the subsidy, which can be directly applied to insurance premium, reducing the amount they pay each month.

Applicants will also find out whether they are eligible for Medicaid or whether they can enroll their kids in CHIP.

After that, applicants can compare the various insurance policies available in their area, including information on deductibles, out-of-pocket expenses, doctor networks and benefits packages.

Plans can be sorted and then compared side by side and are divided into classes from bronze to platinum, based on factors such as the cost and amount of cost sharing (deductible and co-pay levels).

Applicants can enroll and opt to set up premium payments online, or they can call the carrier's customer service department for additional payment options. Those who do not qualify for exemptions, are not covered elsewhere and choose not to enroll in a plan, face fines through the IRS.