For those looking for health insurance, understanding the eligibility requirements for the Affordable Care Act (ACA) can feel like navigating a complex maze. But, with the current state of our healthcare system, it's essential to know whether or not you qualify. That's why we've put together this guide. We'll help you determine if you're eligible for ACA health insurance and help you compare coverage for ACA health insurance marketplace plans.
There are certain eligibility criteria for healthcare coverage under the Affordable Care Act (Obamacare). Here are some eligibility requirements for health coverage plans:
Most people who live in the U.S. are qualified to receive health care under Obamacare; however, certain exceptions apply. This includes:
If you are not a U.S. citizen or national but legally live in the United States, you may be eligible for Obamacare if your immigration status is one of these:
In the next section, we'll cover more on who is eligible for health insurance under ACA based on income.
The amount you spend on insurance and the savings you receive will depend on your household income. The federal poverty level is used to determine if you're eligible for a subsidy using your Modified Adjusted Gross Income (MAGI) to decide on the amount of savings you're eligible for. MAGI is not a number that appears on any of the documents filed with the IRS.
If your household income is between 100% and 400% of the federal poverty level, you're likely eligible for a premium subsidy. If your income is lower than the federal poverty level, you may not be eligible for discounts on an ACA plan or Medicaid based solely on financial status. Learn more about your eligibility for certain health plans.
Obamacare health plans are divided into four tiers: bronze, silver, gold, and platinum. The cost of premiums for each tier differs. The lower the premium is on a plan, the more you'll be expected to pay when receiving care.
These categories, often referred to as "metal plans," help individuals compare different insurance options based on their expected costs and benefits. The four categories are:
All ACA plans must provide a minimum set of health benefits, including preventive care, emergency services, prescription drugs, maternity care, mental health services, and more, regardless of their chosen health plan category. Remember, you can use our comparison tool to compare plans.
Our powerful tool lets you compare plans side by side, so you can find a health insurance plan that provides financial security and peace of mind for you and your family. To learn more about who is eligible for health insurance under ACA, call us today to speak to a licensed insurance agent at 1-800-314-5594 (open Monday - Friday from 8 a.m. to 8 p.m. EST).
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