How to Get Private Health Insurance

Buying a plan through the Health Insurance Marketplace, when you can enroll, help paying premiums, coverage through a job or a parent’s plan, and what to do if your insurance company denies a claim in New Hampshire.

Checked against its sources October 12, 2026.

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APA: Granite Record. (n.d.). How to Get Private Health Insurance. Retrieved November 2, 2026, from https://graniterecord.org/guides/health-insurance
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At a Glance

You can get private health insurance through a job, or buy a plan through the Health Insurance Marketplace, whose official site is HealthCare.gov. You can enroll in a Marketplace plan during Open Enrollment, November 1 to January 15, or after a life change such as losing other coverage, moving or having a baby, and you may get help paying your premiums based on your income. If your insurance company denies a claim, you can appeal to it, and then ask the New Hampshire Insurance Department for an independent external review, which the insurance company pays for.

How will you get coverage?
- Through a jobAsk the employer’s benefits office how and when to sign up.
- On your ownApply for a Marketplace plan, and see if you can get help paying.
- On a low income, at 65, or with a disabilityMedicaid or Medicare may cover you (see “Where Medicaid and Medicare fit”, below).
If your insurance company denies a claim, appeal to it first, then ask the Insurance Department for an external review within 180 days.

Step by Step

Getting coverage

Know when you can sign up
For a plan through the Marketplace, Open Enrollment runs from November 1 to January 15. Enroll by December 15 and your coverage can start January 1; enroll from December 16 to January 15 and it starts February 1, once you pay your first premium. These are HealthCare.gov’s dates. How you apply depends on whether your state has its own Marketplace: HealthCare.gov’s Marketplace in Your State page shows how residents of each state apply.
From January 16 to October 31 you can enroll only with a Special Enrollment Period, which certain life changes open. Among them, in the past 60 days:
- getting married, having a baby, adopting a child or placing a child in foster care;
- moving to a new ZIP code or county;
- losing qualifying health coverage, such as a job’s plan or a parent’s plan when you turn 26, or expecting to lose it in the next 60 days. A loss of Medicaid or CHIP counts within 90 days.
Dropping COBRA coverage yourself does not open one. You may be asked for documents that show the change. Medicaid and CHIP can be applied for at any time.
Dates and deadlines (HealthCare.gov)Special Enrollment Periods (HealthCare.gov)The Marketplace in your state (HealthCare.gov)
Apply
You can apply for a Marketplace plan:
- online at HealthCare.gov, the fastest way;
- by phone, with free help, in other languages too;
- with a local person or organization that helps people apply;
- through a certified enrollment partner, such as an insurance company or an online health insurance seller;
- on a paper application, mailed in. Eligibility results come by mail within 2 weeks.
Ways to apply (HealthCare.gov)
See if you can get help paying
Depending on your income, you may get savings on your Marketplace premiums, or qualify for Medicaid or CHIP instead. Savings are based on your estimate of your income for the year you want coverage, not last year. Count yourself, your spouse if you are married, and everyone you will claim as a tax dependent. You see the exact prices and savings when you fill out the application.
If you have, or are offered, a job-based plan that is considered affordable and meets minimum standards, you will not get savings on a Marketplace plan; most job-based plans meet them. If you already have a Marketplace plan and get an offer of coverage through a job, it may end your savings even if you turn the offer down, so update your Marketplace application.
Income levels and savings (HealthCare.gov)If you have job-based insurance (HealthCare.gov)
Coverage through a job, COBRA, or a parent’s plan
For a plan through your job, ask your employer’s benefits office how and when to sign up.
COBRA lets you and your family keep your employer’s group health insurance for a limited time after an event such as losing your job or having your hours cut. When your COBRA coverage ends, you have 60 days to enroll in a Marketplace plan.
If a parent’s plan covers dependents, you can usually be added to it and stay on it until you turn 26. On a parent’s job-based plan you can generally stay until 26 even if you are married, have a child, live away from home or are not claimed as a tax dependent. On a parent’s Marketplace plan, you can stay through December 31 of the year you turn 26.
Getting or staying on a parent’s plan (HealthCare.gov)

If a claim is denied, or you have a complaint

Appeal a denied claim to your insurance company
Every health insurance company must have a written procedure for appealing a denied claim, with a full and fair review by someone other than the person who denied it. You have at least 180 days after you are told of the denial to appeal, and you may send written comments, documents and records. The company must decide an appeal of a prior authorization or of care already given within 30 days, and an urgent care appeal within 72 hours. You, or someone you authorize, can make the appeal.
Health insurance appeals (Insurance Department)
The law: RSA 420-J:5
Ask the Insurance Department for an external review
If the company still says no, or misses its deadline, you can ask for an independent external review: send a written request to the Insurance Commissioner within 180 days of the company’s final denial. An independent review organization decides. The insurance company pays for the review, it must follow the decision, and it may not retaliate against you for asking.
The Insurance Department’s page says this right is for people covered by fully-insured health or dental plans, that there is no cost to you, and that a standard review may take up to 60 days. Send its External Health Review Form by email or mail.
If your doctor or other provider certifies that waiting would seriously endanger your life or health, or your ability to regain full function, you can ask for an expedited review, even while the company’s own appeal is under way; it is decided within 72 hours. It needs a Provider Certification Form signed by your provider. It is not available for care already given.
This review is not for Medicaid, CHIP or Medicare, except Granite Advantage coverage through a private insurer; for a self-funded employer plan run by an administrator; or for a federal employee plan. Those have their own appeals. Nor is it for a claim of malpractice. Your Explanation of Benefits or the company’s final denial names who handles your external review.
Independent external review (Insurance Department)
The law: RSA 420-J:5-a, RSA 420-J:5-c, RSA 420-J:5-e
Complain to the Insurance Department
The Insurance Department investigates complaints about insurance companies and agents, through a toll-free number and a complaint form. It may tell the company about your complaint, ask it for relief for you, and meet with both of you to settle it, but it cannot decide a claim. When you ask, it helps you through an insurance company’s appeal and an external review. Call its Consumer Services staff at (603) 271-2261, toll free in New Hampshire at 1-800-852-3416, or email [email protected].
New Hampshire Insurance Department
The law: RSA 400-A:15-e, RSA 420-J:5-e

Medicaid and Medicare

Where Medicaid and Medicare fit
Medicaid, a federal and state program, gives free or low-cost coverage to some people with low incomes, families, children, pregnant women, older people and people with disabilities; CHIP covers children and pregnant women in families that earn too much for Medicaid. In New Hampshire you apply through the Department of Health and Human Services. Medicare is the federal health program for people 65 and older and some younger people with disabilities or kidney failure. Each has its own guide (below).

Common Questions

Can an insurance company turn me down because of a health condition?

No. New Hampshire law forbids a health insurance company to base whether you can get or keep coverage on your health, a medical condition, your medical history, genetic information or a disability (RSA 420-G:6). It may not cancel your coverage back to its start except for fraud or an intentional misrepresentation of an important fact, and it may decline to renew it only for the reasons the law lists, such as unpaid premiums.

Is my new baby covered?

A health insurance policy covers a newborn from the moment of birth. If adding a child costs more, the policy may require you to tell the company about the birth and pay within 31 days after it for the coverage to continue; there is no extra premium for those first 31 days (RSA 415:22).

What if I am turned down for a Special Enrollment Period?

You can appeal the decision. HealthCare.gov’s Special Enrollment Periods page explains how.

Can someone appeal for me?

Yes. Someone you authorize to act for you, such as your doctor, can make an appeal to the insurance company or ask for an external review on your behalf.

Who Can Help

The Insurance Department’s Consumer Services, at (603) 271-2261 or toll free in New Hampshire at 1-800-852-3416, for questions and complaints about an insurance company, and help with an appeal. For Medicaid, or advice on your own case:

NH Easy, the Department of Health and Human Services’ benefits site: apply for cash, medical, SNAP (food) and child care assistance, Medicare beneficiary and long-term care assistance, or check first whether you might qualify. To speak to someone, call 1-844-ASK-DHHS (1-844-275-3447).
The New Hampshire Bar Association’s Lawyer Referral Service refers you to a lawyer who handles your kind of problem, for an administrative fee. Call 603-229-0002, weekdays 9:00 AM to 3:30 PM, or ask online.

NH Easy Lawyer Referral Service