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What is ACA Health Insurance?
Affordable Care Act (ACA or Obamacare) health insurance plans were developed to ensure that individuals and families - regardless of their health or pre-existing condition - can obtain affordable health insurance that provides comprehensive medical benefits.
What does ACA Health Insurance Cover?
All Affordable Care Act insurance plans must provide comprehensive coverage that include these 10 essential health benefits:
- Ambulatory patient services (outpatient hospital care)
- Emergency services
- Hospitalization
- Pregnancy, maternity and newborn care
- Mental health and substance use disorder services
- Prescription drug coverage
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
How Do ACA Plans Work?
ACA health insurance plans are categorized into metal levels. Their cost-sharing rules are as follows:
You pay 40%, the insurance company pays 60%.
You pay 30%, the insurance company pays 70%.
You pay 20%, the insurance company pays 80%.
You pay 10%, the insurance company pays 90%.
When Is The Health Exchange Open Enrollment Period?
The Open Enrollment Period for ACA health insurance plans takes place each year from November 1 to December 15 in most states. If you enroll by December 15, your coverage will be effective January 1 of the following year.
What Are ACA Special Enrollment Periods?
Outside of open enrollment, you’ll need to qualify for a Special Enrollment Period to enroll in ACA health plans. You may qualify if you have a life event, such as moving to a new address, having a baby, losing job-based coverage, or getting married.
Outside of the Coronavirus Special Enrollment Period, you usually have up to 60 days from the qualifying life event in which you can sign up for or switch your ACA plan.
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