HealthCare.gov

HealthCare.gov MCP Connector for Claude

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Automate marketplace research via HealthCare.gov — search for health plans, drugs, and providers directly from any AI agent.

11 tools Official Updated Jun 28, 2026 Official Vinkius Partner

Connect the HealthCare.gov Marketplace API to any AI agent and take full control of ACA health plan research and provider network verification through natural conversation.

What you can do

  • Plan Search — Retrieve available health and dental plans based on household demographics and location.
  • Drug Coverage — Search for medications and verify if they are covered by specific plans and at what tier.
  • Provider Lookup — Search for doctors, hospitals, and facilities and check their in-network status.
  • Geography Insights — Retrieve County FIPS codes by ZIP code to ensure accurate regional pricing.
  • Issuer Details — List all insurance companies operating in specific states and their available plans.
  • Crosswalk Access — Monitor plan transitions between enrollment years to stay updated on coverage changes.

How it works

  1. Subscribe to this server
  2. Enter your Marketplace API Key (from developer.cms.gov)
  3. Start researching health plans from Claude, Cursor, or any MCP-compatible client

No more manual filtering through complex marketplace portals. Your AI assistant acts as a dedicated Health Insurance Navigator or Benefits Specialist.

Who is this for?

  • Benefits Consultants — instantly retrieve plan options and pricing for clients across different regions.
  • Healthcare Navigators — automate the process of verifying provider networks and drug formularies.
  • Policy Researchers — maintain a real-time overview of marketplace availability and issuer competition.
aca-planshealth-insuranceprovider-networkdrug-coveragepublic-datamarketplace-api

11 tools expose this connector's capabilities to your AI agent.

get_counties_by_zip

Retrieve County FIPS codes for a given ZIP code

get_plan_crosswalk

Get information about plan transitions between years

get_drug_coverage

Check if a medication is covered by a specific plan

get_api_metadata

Retrieve metadata about the Marketplace API data

get_plan_details

Get detailed information about a specific health plan

get_provider_coverage

Verify if a provider is in-network for a specific plan

list_issuers

List insurance issuers operating in a specific state

list_market_states

List states served by the Marketplace

search_drugs

Search for medications in the Marketplace drug database

search_plans

Pass household and place as JSON strings. Search for health and dental plans in the Marketplace

search_providers

Search for healthcare providers (doctors, facilities)

See how to talk to your AI agent using HealthCare.gov.

Search for health plans in ZIP code 22102.

I've started the search for ZIP 22102. I first need to retrieve the County FIPS code for this area. It belongs to Fairfax County (FIPS: 51059). Should I now proceed to list available Silver plans for a 30-year-old individual?

Check if 'Lipitor' is covered by plan ID 12345VA001.

Checking drug coverage... I found 'Atorvastatin' (Generic Lipitor) in the database. For plan 12345VA001, it is covered as a Tier 1 (Generic) drug with a $10 copay. Would you like to check any other medications?

List all insurance companies operating in Virginia.

Accessing issuer data... In Virginia (VA), there are 8 main issuers operating in the Marketplace, including 'Anthem Health', 'CareFirst BlueCross BlueShield', and 'Kaiser Permanente'. Would you like to see the available plan counts for each?

You must request a free API key through the **CMS Marketplace API** portal (developer.cms.gov/marketplace-api). Keys are typically sent via email and must be renewed every 60 days.

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