ACA Health Plan Basics
If you are new to choosing
an Affordable Care Act (ACA)
health plan, here are a few
helpful things to think about
before we get started. There is
much more than the basics to
consider; we are here to help
you through every step.
ACA Plan Categories
ACA plans are labeled Bronze, Silver, and Gold. Bronze plans have lower monthly premiums and higher out-of-pocket costs, while Platinum plans have higher premiums and lower out-of-pocket costs.
Out-of-pocket costs (deductible, co-payments, and co-insurance) are what you pay when you receive care.
All marketplace plans cover essential health benefits, including doctor visits, hospitalizations, and prescriptions.
Cost Considerations
Many people qualify for subsidies that can lower premiums and out-of-pocket costs. Income and the size of your family determine subsidies. Premiums are the monthly amount you pay for your insurance plan. They vary based on plan type and location.
Choose the Right Provider Network
If you have providers today that you want to keep seeing, check to ensure they are in your plan’s provider network.
Check Prescription Coverage
Each plan can cover drugs differently. Before settling on a plan, understand how your medications are covered and what your out-of-pocket costs will be for them.
Enrollment
Open enrollment for people already enrolled in an ACA plan typically runs from November 1 to December 15. Special enrollment periods are available if you experience specific life changes, such as losing other coverage, moving, or a household income shift.