Affordable Care Act coverage, explained simply
ACA plans (also called Obamacare or Marketplace plans) are health insurance for people who don't get coverage through work, Medicare or Medicaid. Most people who apply get help paying for them.
How a plan can cost $0
The ACA gives a premium tax credit to people who qualify based on income. The credit is paid straight to your insurance company each month, so your bill goes down right away.
If your credit is as large as a plan's premium, that plan costs you $0 a month. Bronze plans are most often $0, and some Silver plans can be too.
$0 premiums depend on household income, household size and location. Not everyone qualifies. You may still have a deductible and copays.
Your price is based on three things
Your expected income for next year, not this year.
Everyone you claim on your tax return.
Plans and prices change by ZIP code and county.
Plan levels: Bronze to Platinum
All levels cover the same essential benefits. The difference is how you split costs with the plan: a lower monthly price usually means you pay more when you get care.
Bronze
Lowest monthly priceBest if you're healthy and mainly want protection from big medical bills. Often $0 with a tax credit.
Silver
Balanced, with extra savingsIf your income qualifies, Silver plans also lower your deductible and copays (cost-sharing reductions).
Gold
Lower costs when you get careA good fit if you see doctors often or take regular prescriptions.
Platinum
Highest price, lowest out-of-pocketFor people who expect a lot of care. Not offered in every area.
What every ACA plan covers
No plan can turn you down or charge you more for a pre-existing condition.
- Doctor visits and outpatient care
- Emergency services
- Hospital stays and surgery
- Pregnancy and newborn care
- Mental health care
- Prescription drugs
- Rehab services and devices
- Lab tests
- Free preventive care and screenings
- Children's care, including dental and vision
When you can enroll
Open Enrollment
Starts November 1. Enroll by December 15 for coverage that starts January 1. Anyone can sign up or switch plans.
Special Enrollment
You usually have 60 days after a qualifying life event to enroll.
Common qualifying life events
- Losing job-based or other health coverage
- Moving to a new ZIP code or county
- Getting married or divorced
- Having a baby or adopting a child
- A change in household income
- Losing Medicaid or CHIP coverage
Not sure if you qualify? Call us and we'll check in a few minutes.
Find out what you'd pay
A licensed agent will walk you through every option. Free.