What is the Affordable
Care Act?
The Affordable Care Act is the comprehensive healthcare reform law enacted in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”). The law has three primary goals:
One
Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level.
Two
Expand the Medicaid program to cover all adults with income below 138 percent of the federal poverty level. (Not all states have expanded their Medicaid programs.)
Three
Support innovative medical care delivery methods designed to lower the costs of healthcare generally.
Is an ACA plan right for you?
Healthcare is essential for you and your family, and finding a plan that fits both your needs and your budget is just as important.
An ACA plan might be right for you if you’re new to buying health insurance, don’t have coverage through your job or prefer choosing your own plan. You could be self-employed, not yet eligible for Medicare or Medicaid, or your employer might offer reimbursements to help with the cost of a plan you purchase independently. Whatever your situation, there are plenty of options to fit your needs
Understanding Gold, Silver, Bronze and Platinum plan levels
When comparing plans on the ACA Marketplace, all ACA plans are categorized as:
Bronze plans
Silver plans
Gold plans
Platinum plans
Generally, categories with higher premiums (Gold and Platinum) pay more of your total healthcare costs, while Bronze and Silver pay less.
This can help you decide which metal level is best for you.
For example, if you don’t think you’ll need regular medical services or prescriptions, a Bronze plan might be a good fit. These plans usually have lower monthly premiums, but higher deductibles and cover less when you need care. On the other hand, if you expect to visit the doctor often or need regular prescriptions, a Gold plan could be a better choice. These plans tend to have higher premiums but cover more of your costs when you need care.
Understand your extra benefits
When picking a healthcare plan, it’s helpful to look beyond just the basics and see what extra benefits are included at no additional cost. These programs can help support your wellness and financial goals.
- Virtual care
- Health & wellness programs
- Behavioral health support and service
- Prescription savings
- Rewards programs
Understand your financial assistance options
Subsidies and cost-sharing reductions can help lower costs for 70-80% of customers, plus there’s extra assistance available to help you pick the best plan for you.
- Subsidies, or advance premium tax credits, help lower the monthly premiums you pay for your health plan. To be eligible, you’ll need to buy an ACA-qualified health plan. Subsidies are calculated based on your annual income.
- Cost-sharing reductions are discounts that lower the amount you owe for deductibles, copayments and insurance. These are only available on Silver plans and are based on your total household income.
Cost-sharing reductions can also help you save on:
- Single/family deductible
- Coinsurance
- Single/family out-of-pocket maximum
- Virtual care
- Primary care visits
- Urgent care
- Specialist visits
- Hospital
- Emergency room
- Prescription drugs
