Health Insurance Plans

Get Quotes & Compare Plans Now

This field is for validation purposes and should be left unchanged.

Health Insurance Plans

Get Quotes & Compare Plans Now

Health Insurance Plans

This field is for validation purposes and should be left unchanged.

Health Insurance 101:

Understanding the Affordable Care Act and Your Health Insurance Options

When it comes to selecting a health insurance plan, it helps to understand what your options are. It all starts with the Affordable Care Act (ACA), commonly referred to as Obamacare. The Affordable Care Act was passed in 2010 and was focused on improving health insurance access and consumer rights. The goal was to create greater access to healthcare for everyone and provide more affordable health insurance.

How the Affordable Care Act Works for You

With ACA everyone qualifies for affordable healthcare. Before the ACA took effect, some people couldn’t get coverage while others with health insurance were forced to deal with lifetime dollar limits. With the Affordable Care Act, those issues and so many others like them no longer apply.

No denial of coverage OR higher premiums for individuals with pre- existing health conditions.

If insurance companies want to increase your rates by 10% or more, they have to publicly provide a reason for doing so.

No lifetime limits on essential coverage provided to individuals with chronic ailments.

Insurance companies can no longer drop your health insurance due to a mistake made on your application.

Insurance companies must spend at least 80% of your insurance premium on things such as medical care and quality improvements.

If you’re not covered by your place of employment, affordable healthcare is at your fingertips.

Health care prices are staying steadier than ever before.

The best part is that all of the ACA Marketplace plans are the same. That means that regardless of which one you pick or who provides them, they all provide the same healthcare coverage for you.

Ready to get Health Insurance? Let us Help!

Get Started Online

Call a licensed insurance agent (877) 354-4165

ESSENTIAL BENEFITS EVERY PLAN PROVIDES

The Affordable Care Act increased the protection for consumers and now every ACA approved health plan must cover the following 10 essential benefits

Ambulatory patient services

Outpatient care received without being admitted to the hospital

Emergency services

Care received in the emergency room

Hospitalization

Care received during a hospital stay

Maternity and newborn care

Care received before and after your child’s birth

Laboratory services

Services performed by a laboratory, such as drug tests, blood tests, and urinalyses

Mental health and substance use disorder services

Behavioral health treatment including counseling and pyschotherapy

Prescription drugs

Medicines prescribed by your doctor

Rehabilitative and habilitative services and devices

Services and devices that help people with injuries, disabilities, and/or chronic conditions to gain or recover mental and physical skills

Preventive and wellness services and chronic disease management

Shots and screening tests

Pediatric services, including oral and vision care

Services for children EXCLUDING dental care

MEET THE AFFORDABLE CARE ACT PLANS

There are four metal levels of coverage available under the Affordable Care Act. Each of these plans pay different amounts of your total healthcare costs based on the monthly premiums, deductibles, copayments, coinsurance, and out-of-pocket maximums. However, the benefits of every plan type remain the same making it now easier than ever to find a plan that meets both your budget and your healthcare needs.

Your health plan pays an average: 60%

You pay about 40%

Your health plan pays an average: 70%

You pay about 30%

Your health plan pays an average: 80%

You pay about 20%

Your health plan pays an average: 90%

You pay about 10%

Subsidies: Making Health Insurance affordable for everyone

A subsidy is financial assistance from government programs that assist people in the lower to middle income brackets with their individual health insurance costs. A subsidy is not a loan, it does not need to be paid back if your income is below the earning threshold.

To qualify for a subsidy, you must meet requirements for household size and household income. Based on the requirements, you may qualify for premium tax credits, lower out-of-pocket costs, or low-cost health care through Medicaid. If you qualify for lower out of pocket costs your quotes will reflect this. Only silver plans currently qualify for this benefit.

If you qualify for premium tax credits to help you afford the monthly health insurance premium you will be notified as part of the application process. You can use these tax credits right away, and you can apply any amount on up to the complete amount of the credits to your premium each month. Important points to remember:

  • If the advance credit payments received for the year are less than the tax credit due to you, then you’ll receive the difference as a refundable credit when you file your federal income tax return.

  • If the advance credit payments received for the year are more than the tax credit due to you, then you must repay the excess advance payments with your federal income tax return.

You can check to see if you qualify for a subsidy

Time to Start Shopping? Let us Help!

Get Started Online

Call a licensed insurance agent (877) 354-4165

Important Dates – ACA Open Enrollment Period

This period only happens once per year and gives everyone the opportunity to sign up for affordable healthcare.

November 1st to January 15th

During the open enrollment period you are free to change plans for the year. This is the perfect time to shop the plan options available to you and make sure you have the coverage you want at the right price. While the services covered are the same between plans, the prices may not be. It pays to check every year to make sure you are getting the best health insurance plan for your needs.

Missed Open Enrollment?

You still have options. If you have experienced certain life events recently you may qualify for a Special Enrollment Period. Special Enrollment Periods allow you to sign up for obamacare certified plans outside of the open enrollment period. Qualifying life events include:

Moved to a new zip code

Lost or Losing Current Coverage

Changes to Your Income

Change in Disability Status

Change in Family Size (marriage, divorce, new child)

Loss of Eligibility for Medicaid and/or CHIP

Gaining Lawful Residence & Citizenship

Leaving Incarceration

If you missed open enrollment and don’t qualify for a special enrollment period Short Term Insurance is a great option to cover any gaps in coverage. For more information see our Short Term Coverage information page.

If you do not have health insurance after the open enrollment period AND you do not have a health coverage exemption, then you will have to pay tax penalties.

How do I buy an ACA Health Insurance plan?

Obamacare plans are available through your state’s health insurance exchange, the federal health insurance exchange or directly from an insurance company. Health Matchup works with our trusted partners to give you instant access to all of the ACA Health Insurance Plans in your area. By filling in our easy to use quote form we’ll match you with all of your options in one location.