Affordable health insurance plans for you and your Family
Explore ACA health plans available in your area.
What is the affordable care act?
The healthcare reform legislation, known as the Affordable Care Act (ACA), and its subsequent modifications, aim to improve issues related to health insurance coverage, expenses, and preventive healthcare.
The ACA has opened up the possibility for individuals previously without coverage due to preexisting conditions or financial limitations, as well as those who were enrolled in high-cost or limited-benefit plans, to potentially access more reasonably priced health insurance options featuring essential benefits. This legislation has extended access to quality healthcare to numerous individuals.
Health plans that comply with the ACA offer services such as annual health checkups, maternity and newborn care, prescription medications, emergency medical services, mental health support, pediatric care, and more.
What does ACA Covers?
10 Essential benefits offered by ACA
Emergency services
Coverage for unforeseeable medical emergencies requiring immediate treatment.
Hospitalization
Refers to someone admitted to the hospital to stay overnight, whether briefly or for an extended period of time.
Outpatient Care
Also called ambulatory care, it defines any service or treatment that doesn’t require hospitalization.
Pregnancy, maternity, and newborn care plus Pedicatric services
These are services that care for you and your baby before, during, and shortly after giving birth. Pediatric services includes dental care, vision care, well-child visits, vaccinations
Mental health and substance use disorder services
This includes services to treat behavioral health, provide counseling, or provide psychotherapy.
Prescription drug coverage
Prescription drugs are a standard part of medical treatment plans
Rehabilitative and habilitation services and devices
These services help you recover if you are injured, have a disability, or have a chronic condition. Services may include physical therapy, occupational therapy, or speech therapy.
Laboratory services
This includes testing to diagnose, to gauge effectiveness, and some preventive screenings.
Preventive and wellness services and chronic disease management
Take advantage of covered preventive care services to help you stay healthy.
ACA Plan options
ACA health insurance plans 'Metal' categories
All metal plans cover the same set of essential health benefits and do not affect the quality of care you’ll receive. The categories are based on how you and the plan will share the costs for health care services.
Bronze Level
Bronze-level plans usually come with the most affordable premiums but feature higher deductibles and additional out-of-pocket expenses.
These plans are a wise option if you seek security against potential severe medical situations.
Silver Level
Silver plans come with a moderate premium and cost for healthcare services.If you meet the requirements for cost-sharing reductions, choosing a Silver plan grants you additional savings.
Opting for these plans is a suitable decision if you're comfortable paying a bit more for your healthcare to enjoy a lower premium, especially if you're eligible for extra savings.
Gold Level
Gold plans features higher premiums but reduced expenses when accessing medical services. These plans are a favorable option if you require extensive healthcare.
Platinum Level
Platinum plans offers the lowest expenses for healthcare services but the highest premiums. Choosing these plans is a wise decision if you require substantial medical care and have the means to manage a higher monthly premium in order to reduce other out of pocket cost.
Frequently Asked Questions
You can sign up for an individual major medical plan once a year during the annual open enrollment period. In most states for 2023, open enrollment takes place from November 1 through January 15th. year.
Yes, You’ll need to qualify for a special enrollment period due to a life event such as moving to a new ZIP code, having a baby, losing job-based coverage, or getting married. A special enrollment period offers a brief amount of time, usually up to 60 days from the qualifying life event in which you can sign up for or switch your ACA plan.
Yes, tax credits and subsidies are available based on income to make ACA plans more affordable.
Premium tax credits are based on factors like income and family size. They can help lower your monthly premium costs for ACA plans.
The ACA prevents insurance companies from denying coverage or charging more due to pre-existing conditions.
If you have Medicaid coverage, you might not need to apply for health insurance through the ACA marketplace. Medicaid is a government program that provides healthcare coverage to eligible low-income individuals and families. If you qualify for Medicaid, you likely have access to comprehensive healthcare coverage through that program.
It’s possible for your children to qualify for the Children’s Health Insurance Program (CHIP) while you explore health insurance options through the ACA marketplace.
As for adults, you can apply for health insurance through the ACA marketplace. The ACA marketplace offers health plans that provide coverage for adults and families who may not qualify for Medicaid or CHIP and are looking for individual or family health insurance options.
ACA plans often have networks, so it’s important to check if your preferred providers are in-network.
No, if you have Medicare coverage, you generally cannot apply for health insurance through the ACA marketplace. Medicare is a federal health insurance program primarily for individuals who are 65 and older, as well as certain younger people with disabilities.
If you miss the Open Enrollment deadline, you may have to wait until the next enrollment period unless you qualify for a Special Enrollment Period.
If you move to a different state, you can select a new ACA plan within your new state’s marketplace. Your eligibility and plan options might change.
Some ACA plans offer dental and vision coverage as separate add-ons, but they are not automatically included in all plans.
You can check your ACA plan’s formulary to see if your medications are covered. Plans are required to cover essential prescription drugs.
You should promptly report changes in income or household size. Contact us to help you apply the changes to ensure accurate premium tax credits and coverage adjustments.