Health Insurance for Individuals and Families
Are you looking for a health care plan through the Affordable Care Act (ACA) Marketplace as sold via healthcare.gov? We’ve got you covered. We help individuals and families find affordable, reliable coverage that will fit their needs. Plus, the recent Inflation Reduction Act of 2022 has allowed many families to find coverage for even lower monthly premiums.
Do you need short term medical insurance to fill the gap? We can help there, too.
What are ACA Plans?
The Patient Protection and Affordable Care Act, more commonly referred to as the ACA, was signed into law during President Obama’s term in 2010. This is why so many people also refer to these plans as Obamacare. The goal of the ACA was to improve the accessibility, affordability, and quality of health insurance across the country.
Prior to the ACA, many Americans struggled to afford or even obtain health insurance because of pre-existing medical conditions. Obamacare significantly reduced the number of uninsured people in the U.S.
ACA plans are sold on the Marketplace or Exchange. Individuals and families can enroll in an ACA plan rather than an employer-sponsored or private plan. Pre-existing conditions won’t prevent you from enrolling in an ACA plan. In addition, many people receive tax credits and subsidies to reduce their premiums.
Every ACA plan must include the TEN Essential Health Benefits (EHBs). These Health Benefits include:
Hospitalization
Emergency services
Ambulatory services
Prescription drugs
Maternity and newborn care
Mental health and substance abuse services
Lab tests
Chronic disease management, preventive, and “well” services
Pediatric dental and vision care
Rehabilitative services
What are My Options?
You’ve got options when it comes to health insurance. The most important thing is to understand the type of plans available, so you can pick the one that fits your and your family’s needs. Two of the most common plan types are Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs).
• HMO Insurance Plans
HMO insurance plans require members to get care within their network of doctors and hospitals. You will only have coverage if you stay within the network. You’ll select a primary care physician who will coordinate all the care you receive, even from specialists. Usually, the premiums and out-of-pocket costs for HMO plans are cheaper than those of PPO plans.
• PPO Insurance Plans
PPO insurance plans also use networks but give members more flexibility. You can receive care outside the network, though you might pay more if you choose to do so. You won’t have to choose a primary care physician or obtain referrals to see specialists.
How Much Do ACA Plans Cost?
The Affordable Care Act did more than just provide us with new health insurance options. It also included many provisions that expanded eligibility for Medicaid, prohibited discrimination based on pre-existing conditions, and allowed for premium subsidies for individuals and families with limited incomes.
Premium tax credits reduce the premium you pay for an insurance plan purchased through the ACA. Not everyone will qualify for a tax credit as they are based on your household income. You’ll answer questions about your income during the application process. At that time, you’ll find out if you’re eligible for subsidies.
You’ll also have deductibles, coinsurance, and copayments, all based on which plan you choose. Plans are categorized by metal tiers. Platinum plans offer the most coverage, with Gold, Silver, and Bronze following.
Get Help Choosing Health Insurance
Health insurance is confusing. The good news is that you don’t have to do it alone! We will guide you during your selection, taking the time to understand your health needs and budget.
Even if it’s not Open Enrollment, we can still start looking at ACA health insurance options for you. Remember, you may qualify for a Special Enrollment Period and might be able to get the coverage you need sooner than you think. Call us today to get started!
Don't Risk Getting the Wrong Coverage
Work with us!
We understand insurance can be difficult to understand. This is why we strive to educate and empower our clients to make the best decisions for their coverage and peace of mind.
