Overview

What does the Marketplace API offer?

The Marketplace API delivers data that helps users find and evaluate health care insurance plans, providers, and coverage information on the marketplace. It’s used by HealthCare.gov and other third party services.

Here are the data types in the Marketplace API:

  • Affordable Care Act (ACA) plan benefit and rating data from issuers on the exchange
  • Doctor, facility, and drug coverage for ACA plans
  • Out-of-pocket-cost utilization data as calculated on behalf of CMS
  • Medicaid and the Children’s Health Insurance Program (CHIP) eligibility estimate data

Why should I use this API?

Applications that use the Marketplace API can get live changes as soon as they’re posted on HealthCare.gov instead of loading them from a static data source (like PUF or QHP Landscape files). This lets you keep your plan data up to date and in sync with the Marketplace, so your users have the most accurate information to help them make decisions.

The Marketplace API is designed to support live access by front-end applications, it’s not designed to be scraped or for the whole data set to be extracted.

Who can use the Marketplace API?

API keys can be issued to anyone who requests access and is granted a key.

How can I start using the Marketplace API?

You can request access here: Marketplace API Key Request


Getting started

You can find Marketplace API documentation on Marketplace API Documentation


Use cases

Powering HealthCare.gov

The Marketplace API drives Window Shop and Plan Compare on HealthCare.gov. Window Shop lets consumers preview plans and prices before they start the application and enrollment process. Plan Compare lets users pick the plan they want to enroll in after logging in. These products show consumers:

  • Plans available to them based on their location and household makeup.
  • If plans cover their specific providers and drugs.
  • Their estimated total yearly costs based on how much health care they expect to use.

Third Party Adoption

Direct Enrollment partners use the Marketplace API to power their health insurance enrollment applications.

You can use the Marketplace API to:


Machine readable tools

Machine Readable Tools are a newly redesigned self-service way for users to troubleshoot machine readable issues. Included are:

  • JSON Validator: Check your JSON schema for errors, and how to troubleshoot them.
  • Coverage Inspector: Find coverage information about issuers, providers, plans, and drugs.
  • Knowledgebase FAQ: Need help? The knowledgebase is here to assist you.

Visit the Marketplace API coverage portal to learn more, and get started.


Support

If you have questions or issues, contact us at: marketplace-api@cms-provider-directory.uservoice.com