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What Are the Benefits of ACA Health Insurance?

December 11, 2023

What Are the Benefits of ACA Health Insurance?

Want to learn about the advantages of health plans under the Affordable Care Act (ACA)? An ACA plan can offer essential health benefits to help you stay healthy and avoid unexpected medical bills. Check out this guide for information on ACA health coverage, its advantages, and more.


What is the Affordable Care Act?


The Affordable Care Act, also referred to as Obamacare, is a reform law that was passed in the United States to improve health coverage for Americans. It requires insurance providers to cover essential health benefits like prescription drugs, pregnancy care, and emergency services. The law has three primary goals:

  1. Make affordable health insurance more accessible to Americans by providing subsidies to lower costs.
  2. Support medical care delivery methods to lower costs of healthcare overall.
  3. Expand the existing Medicaid program to cover low-income adults.

The law brings some uniformity to healthcare and is meant to serve as a foundation for health insurance coverage in the country. It has transformed the way Americans shop for healthcare benefits. If you're interested in learning about the benefits of ACA health insurance, then you'll want to keep reading below.

What is ACA health insurance?

ACA health plans refer to coverage options that came about as a result of the Affordable Care Act. You can get access to the Health Insurance Marketplace to begin your search and find insurance plans online that fit your medical needs. ACA health plans are typically categorized into different levels depending on their actuarial values:

  • Bronze: You pay 40% and the company pays 60%
  • Silver: You pay 30% and the company pays 70%
  • Gold: You pay 20% and the company pays 80%
  • Platinum: You pay 10% and the company pays 90%

If you're interested in enrolling, you can sign up for an individual major medical plan once a year during the annual enrollment period. This takes place between November and December.

In the event that you miss the open enrollment period, you can qualify for a special enrollment period due to a major life event. This can include moving to a new zip code, having a baby, losing job-based coverage, or getting married. This special enrollment period typically offers you up to 60 days to enroll following the qualifying life event.

What are the benefits of ACA health insurance?



Some of the key provisions of the ACA have helped provide higher-quality care to Americans when it comes to basic healthcare services like emergency services and hospitalization. Check out some of the main benefits of ACA health insurance below.


Coverage for Essential Health Benefits

With ACA insurance, you have access to a variety of coverage options and benefit plans that cater to your specific needs. At a minimum, you'll get health coverage for ambulatory patient services, emergency care services, hospitalization, pregnancy and maternity care, mental health and substance use disorder services, prescription drug coverage, rehabilitative services and devices, laboratory services, preventative services, and pediatric services that include oral and vision care.


Affordable Healthcare Options for Individuals and Families Without Job-Based Benefits

The law ensures individuals and families who don't qualify for job-based coverage can obtain affordable healthcare through guaranteed issue major medical insurance. Plans will come in different costs depending on the individual or family's care needs. You can also qualify for income-based subsidies to lower your premiums and out-of-pocket expenses.


No Coverage Denial or Upcharge Based on Gender or Pre-Existing Conditions

Before the ACA, insurance companies can upcharge or refuse to cover you based on your gender or medical history. For example, if you suffer from chronic conditions like asthma, diabetes, or cancer, an insurance provider would be able to charge you a higher copayment for a doctor's visit.

Under the Affordable Care Act, this is no longer allowed. It's one of the many benefits of ACA health insurance. You cannot be denied coverage or charged more based on factors such as your gender or your health history.


Specified Screenings and Preventive Care at No Additional Cost

You'll have greater access to certain preventive health benefits at no additional cost to your health plan. This typically includes certain screenings, vaccinations, or condition-related counseling. You will not be charged a co-payment or coinsurance for these specific preventive services even if you haven't met your plan's deductible yet.


No Time Limits on Care

Another benefit is that insurance companies can no longer maintain a preset limit on coverage for customers. Providers used to set limits on the amount of money they could spend on an individual, and people with chronic health conditions would typically run out of insurance coverage.


Prescription Drugs Are Less Expensive

Insurance under the Affordable Care Act covers a number of prescription medications and generic drugs. Every year, the list grows larger, allowing more Americans to afford their prescriptions with price reductions. Although the health care law did not institute system changes to the pricing of medications, out-of-pocket prescription costs are greatly lowered under these health plans overall.


What is the downside of ACA?

While there are many benefits of ACA health insurance, there are some downsides to these health plan choices. Taxes and premiums have gone up as a result of the reform law. But overall, this type of insurance and its benefits have increased the number of people with health coverage and made specific services more accessible to a larger number of Americans.


How do you find an ACA health insurance plan?



For ACA plans, you can speak to a licensed insurance agent by calling 1-800-314-5594. You can also compare plans online and learn more about your options by answering our ACA health insurance questionnaire. This section of our website allows you to find affordable healthcare options that suit your needs. Every plan varies in both cost and coverage, and you can choose depending on your healthcare needs. Our licensed insurance agents can also help you determine eligibility for a subsidy which will lower your premium and deductible.


If you're interested in learning more about getting insured, you can check out our Learning Center. We have guides on saving on healthcare costs, how to navigate Medicare, and even how you can prepare for your first telemedicine appointment. You'll find that our site has comprehensive information about insurance options as well as navigating your health needs.

In conclusion, ACA health insurance is crucial for your well-being as it offers a range of benefits that can keep you healthy and financially stable. With the benefits of ACA health insurance, you can obtain quality healthcare services, coverage for pre-existing conditions, and affordable premiums. Altogether, ACA health insurance is a great option to ensure that you have access to the healthcare you need when you need it. From finding a plan and going over benefits to obtaining your own coverage and learning about co-payments, you can utilize our website to ensure you're always prioritizing your health. Feel free to speak to any of our licensed insurance agents or start browsing information online today.


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