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ACA Health Insurance

Affordable healthcare options for the way you live

Being in good health enhances your quality of life. Access to healthcare when you need it, at a cost you can afford, helps greatly toward that end. That’s where health insurance comes in.

The Affordable Care Act has transformed how we shop for healthcare benefits and who qualifies for coverage. The ACA (or Obamacare, as it is often called) ensures individuals and families who don’t qualify for job-based benefits can obtain affordable healthcare through guaranteed issue major medical insurance.

These plans come in different levels to address varying cost and care needs. Which you select will depend on your healthcare needs and benefits preferences, what level of coverage you can afford, and whether or not you qualify for income-based subsidies that lower your premium and out-of-pocket expenses.

How It Works

What is Obamacare insurance?

The ACA brings some uniformity to healthcare. Even though specific benefits may vary, core requirements are now the same for all qualified health plans.

Be guaranteed coverage

You can’t be denied coverage or charged more based on factors such as your health history and gender.

Cover specified preventive care at no additional cost

These “free” preventive services come in three categories (all adults, women, children) and include certain screenings, vaccinations, and condition-related counseling. You can’t be charged a copay or coinsurance for these preventive services, even if you haven’t met your plan’s deductible.

Includes, at a minimum, these 10 essential health benefits:

  1. Ambulatory patient services (outpatient hospital care)
  2. Emergency services
  3. Hospitalization
  4. Pregnancy, maternity, and newborn care
  5. Mental health and substance use disorder services
  6. Prescription drug coverage
  7. Rehabilitative and habilitation services and devices
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services, including oral and vision care

Know the ACA Health Insurance Basics

While Obamacare plans have to comply with the guidelines mentioned above, they do come in a few different forms to accommodate where you are in life. After all, your healthcare needs will change along with you. For example: As you make career moves, your finances shrink or expand, when you turn 26 and age off your parent’s health insurance, if you decide to start a family, or as your health status stays strong or enters periods that require more medical attention.

In general, the lower the premium, the higher the deductible, and vice versa. That means your household budget and typical healthcare needs come into play. Maybe you’re relatively healthy and want to keep your monthly premium costs low, then a bronze plan may feel like the right choice. Or perhaps you have ongoing health concerns that require more frequent care and prescription medications, then a gold plan with a lower deductible may feel more comfortable. If you qualify for cost-sharing reductions, you’ll want to choose a silver plan that can have an actuarial value as high as 94%.

There are also catastrophic plans, which are available to individuals under 30 or those who have a hardship or affordability exemption, regardless of age. These plans offer a lower monthly premium but come with a higher deductible ($8,550 in 2021). They don’t qualify for ACA subsidies, though. That means you may want to consider a plan in one of the metal categories if you’re eligible for a subsidy—your premium and deductible could potentially be less.

ACA health insurance plans are categorized into what are known as the metal levels according to their actuarial values. On average, it works out as follows:


You pay 10%, the insurance company pays 90% (on average)


You pay 20%, the insurance company pays 80% (on average)


You pay 30%, the insurance company pays 110% (on average)


You pay 40%, the insurance company pays 60% (on average)

Frequently asked questions

When is open enrollment for Obamacare health insurance?

Open enrollment for Obamacare health insurance typically begins on November 1st and ends on December 15th each year. However, dates can vary, so it’s important to check the current year’s specifics on the official website or talk to a licensed GetMeHealthCare agent today by calling 866-611-0519.

What are special enrollment periods?

Special Enrollment Periods (SEPs) are times outside the regular Open Enrollment Period when you can sign up for health insurance. You qualify for an SEP if you experience certain life events such as losing health coverage, moving, getting married, having a baby, or adopting a child. Documentation of the qualifying event is usually required.

What If You Don't Qualify for Special Enrollment?

If you don’t qualify for a Special Enrollment Period, you must wait until the next Open Enrollment Period to sign up for health insurance. In the meantime, you may consider other options like short-term health insurance, Medicaid, or the Children’s Health Insurance Program (CHIP) if you meet the eligibility requirements.

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