Health Application Checklist

When you apply for or renew your coverage in the Health Insurance Marketplace, you’ll need to provide some information about you and your household, including income, any coverage you currently have, and some additional items.

Use the checklist below to help you gather what you need to apply for coverage.



  • Information about your household. Figure out who's applying for coverage before you start your application. Visit HealthCare.gov/income-and-household-information/household-size for help figuring out who needs coverage.
  • Home and/or mailing addresses for everyone applying for coverage.
  • Information about everyone applying for coverage.
  • Social Security Numbers.
  • Information about the professional helping you apply (if you’re getting help completing your application). Visit HealthCare.gov/help/whos-helping-me-complete-my-application for more information.
  • Document information for legal immigrants. Visit HealthCare.gov/help/immigration-document-types for more information.
  • Information on how you file your taxes.
  • Employer and income information for every member of your household (for example, from pay stubs or W-2 forms—Wage and Tax Statements). Visit HealthCare.gov/income-and-household-information/income to learn more about what types of income to include and not include.
  • Your best estimate of what your household income will be in 2016. Visit HealthCare.gov/income-and-household-information/how-to-report for help estimating your income.
  • Policy numbers for any current health insurance plans covering members of your household.
  • A completed "Employer Coverage Tool" for every job-based plan you or someone in your household is eligible for. (You’ll need to fill out this form even for coverage you’re eligible for but don’t enroll in.) Visit HealthCare.gov/downloads/employer-coverage-tool.pdf to view or print the tool. 

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