The Affordable Care Act:
The Affordable Care Act (ACA), commonly referred to as Obamacare can be confusing. We're here to give you the need-to-knows and guide you to the best coverage, helping you find a plan that fits your needs.
Obamacare was passed in 2010 and created stronger consumer rights and protections, more affordable healthcare, and better access to health insurance.
ACA Open Enrollment Period
This period only happens once per year and gives everyone the opportunity to sign up for affordable healthcare.
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
Changes to your income
Changes to family size (due to marriage, divorce, or a new child.)
Gaining lawful residence & citizenship
Lost or losing coverage
Change in disability status
Loss of eligibility for Medicaid and/or CHIP
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 OEP AND you do not have a health coverage exemption, then you will have to pay tax penalties. See the Tax Penalties section to see how much not having insurance will cost you this year.
With Obamacare 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 Obamacare, 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.
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 insurance companies want to increase your rates by 10% or more, they have to publically provide a reason for doing so.
Health care prices are staying steadier than ever before.
If you’re not covered by your place of employment, affordable healthcare is at your fingertips.
Whether or not you use tobacco
Where you live
If you can claim dependants (spouse/child)
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
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
Laboratory services –services performed by a laboratory, such as drug tests, blood tests, and urinalyses
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
There are four metal levels of coverage available under Obamacare. 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. These metal plan levels mean it’s 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%
Catastrophic Plans are also available to people under 30 and those with a Hardship Exemption. Catastrophic plans have low monthly premiums but require you to use a lot of care services before they will cover costs. They are designed to help in worst-case scenarios such as accidents or serious illnesses.Compare Metal Plans
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.
2.5% of your annual household income - The amount of income above the tax filing threshold (about $10,150 for an individual) is used to calculate the penalty. The maximum penalty is the national average premium for a Bronze plan.
$695 per person for the year ($347.50 for each child under the age of 18) - The maximum penalty for one family using this method is $2085.
*An executive order was signed on Jan. 20, 2017, that directed federal agencies to exercise their authority and discretion to reduce potential burden. Consistent with that, the IRS decided to allow electronic and paper returns to be accepted in instances where a taxpayer doesn’t indicate their coverage status. However, legislative provisions of the ACA law are still in force and taxpayers remain required to follow the law and pay what they may owe until changes are made by Congress.
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 Obamacare 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.Shop Plans