The Affordable Care Act brought affordable health care insurance to wider public availability. Though, many people don’t understand exactly how the health insurance marketplace works. Here are answers to some frequently asked questions about ACA plans.

What Are ACA Plans?

ACA-compliant plans are health insurance plans that are coherent with the Affordable Care Act’s health reform regulations. All new health insurance plans are required to be ACA compliant. To be ACA compliant, they must offer ten essential health benefits. ACA-compliant plans must also allow Open Enrollment with no underwriting at certain times of the year. This means you can’t be denied coverage or charged more due to pre-existing conditions during the Open Enrollment Period.

What Is Open Enrollment?

The Open Enrollment Period is an annual period that occurs in the fall. During this time, people can enroll in a health insurance plan for the next calendar year. If you miss the Open Enrollment Period, you may be able to enroll during a Special Enrollment Period.

What Are Special Enrollment Periods?

Special Enrollment Periods are conditional enrollment periods that are offered to people who have experienced specific life events that may have limited their ability to enroll in an ACA plan. To find out if you qualify for a Special Enrollment Period, contact an insurance specialist.

What Are The Ten Essential Health Benefits?

You may have heard that ACA plans are required to offer ten essential health insurance benefits. The benefits all plans must offer include:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity, and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care

What Types Of Plans Are Available?

Plans in the Marketplace are separated into categories. They are Bronze, Silver, Gold, and Platinum. The category is decided based on the amount of cost sharing they require. Cost sharing refers to out-of-pocket costs, like deductibles, co-pays, and co-insurance. For a majority of medical services, you’ll need to pay some of the cost until you reach the annual out-of-pocket limit on cost sharing.


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Get Started With ACA Coverage

ACA coverage can offer you the health insurance coverage you need at an affordable cost. To start exploring the Marketplace or submit an application, call American Family Solutions. We can guide you through the process and help you secure the insurance you need.