How Do ACA Health Plans Work?

Today we're going to talk about how ACA health plans work. ACA health plans, also known as Marketplace or Obamacare plans, are designed to help individuals and families without employer coverage get affordable health insurance. These plans are required to cover ten essential health benefits, including things like emergency care, hospitalization, maternity care, mental health services, preventive care, and prescription drugs.

One of the biggest benefits of ACA plans is the financial help available. Most people qualify for income-based subsidies called premium tax credits, which can lower your monthly premiums by hundreds of dollars per month. If your income is on the lower side, you might also qualify for cost-sharing reductions that lower your deductibles, copays, and other out-of-pocket costs.

Enrollment for ACA health plans usually only happens once a year during the Open Enrollment Period (OEP). This usually runs from November 1st to December 15th, but if you experience a qualifying life event like losing your job-based coverage, getting married, having a baby, or moving to a new state, you are be able to sign up during a Special Enrollment Period (SEP) any time of the year due to this being a Qualifying Life Event (QLE).

As your local health insurance agent, I help people every day figure out if they qualify for subsidies, compare plans, and pick the one that fits their needs and budget best. If you want to see what you qualify for or need help navigating the Marketplace from someone with years of experience, call me at 615-579-7592 or email joel@wellnessinsurance.info and I’ll walk you through the process all at no cost to you.