Health insurance can be expensive in the US, especially when your company doesn’t provide it. If you’re shopping around for options during the enrollment period this fall, checking out health plans through the Affordable Care Act is a good way to start.
Signed into law by former President Barack Obama in 2010, the Affordable Care Act was designed to give more Americans access to affordable health insurance. The law also expands the Medicaid program and supports new medical delivery methods — such as ACA Health Homes — that aim to lower the costs of health care. More than 35 million Americans are enrolled in Affordable Care Act related coverage, President Joe Biden announced on Aug. 2.
We’ll tell you when open enrollment begins for health plans under the Affordable Care Act and how to sign up at HealthCare.gov. For additional reading, here’s the best time to .
What health insurance plans are available under the Affordable Care Act?
The state you live in determines which health care providers you can use, assuming you qualify for the Affordable Care Act (see below). For each plan, you should see Bronze, Silver, Gold and Platinum options. Here’s a breakdown of how each plan works.
Bronze: You’ll pay the lowest monthly premium, but you’ll pay more when it comes to paying for care. The Bronze plan deductible is generally much higher than the other options, so you’ll pay more out of pocket until your deductible is met.
Silver: This middle-of-the-road coverage comes with a moderate monthly premium. It will cost you more than the Bronze option, but your costs for medical treatment will be less than if you went with the Bronze plan.
Gold: This plan includes a high monthly premium, and low costs when you need health care. A low deductible means the amount of medical costs you pay out of pocket will be much less than with the Bronze and Silver plans.
Platinum: The most expensive monthly premium gives you the lowest costs when it comes to medical care. Since the deductible is very low, your plan will start paying your medical costs sooner than any of the other options.
Deciding which plan to choose depends on your lifestyle, how often you’ll need health care and what sort of medical treatment you require. For instance, if you’re healthy and only expect to need to use your insurance for emergencies, you might opt for the Bronze or Silver plan. If you are currently receiving treatment or expect to need regular medical attention, the Gold and Platinum options could be the best options for you.
If you are under 30 years old or have an exemption based on inability to afford health insurance, you can qualify for a Catastrophic plan, which has a very low monthly premium and a very high deductible.
Note that your premium is based on your income, so if you have a lower income, your premium could cost less.
How to find out if you qualify for an Affordable Care Act plan
Before you start thinking about which plan you’ll choose, you should first find out if you actually qualify for the Affordable Care Act. Go to healthcare.gov/screener/ and enter your ZIP code. Depending on where you live, you may be redirected to a different website.
You’ll next answer a few questions to see if you qualify for discounted or full-price coverage. Once you get an answer, your next step is to complete an application with either the Health Insurance Marketplace or your state’s own marketplace to see plans and prices.
When can you sign up for a health care plan from the Affordable Care Act?
Open enrollment begins Nov. 1 and continues through Jan. 15. Outside of those dates, you may be eligible for special enrollment. Here’s how you may qualify:
You had a life-changing event in the past 60 days: The events include losing health coverage, a change in household income, having a baby, getting married, getting divorced, moving to a new ZIP code or if someone on your Marketplace plan died.
Note that if you moved to a new ZIP code, you must show proof that you had insurance for at least one day during the past 60 days, or that you’ll lose coverage in the next 60 days. Also, if you’ve lost your job and decide not to accept COBRA (Consolidated Omnibus Budget Reconciliation Act) coverage, you can still enroll in a Marketplace plan.
You’re applying for Medicaid or the Children’s Health Insurance Program (CHIP): If you’re applying for either of these programs, you can apply for health insurance via the Marketplace at any time.
Other life circumstances that could qualify you:
- You’re getting out of prison
- You just became a US citizen
- You’re starting or ending service in AmeriCorps
- You’ve gained membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
To see if you qualify for special enrollment, follow the steps above at healthcare.gov/screener/. If you’re eligible, your health care plan would begin the first of the month after you enroll. For instance, if you enroll in August, your coverage would begin on Sept. 1.
How to sign up for an Affordable Care Act health care plan
Once you’re ready to sign up — whether it’s between Nov. 1 and Jan. 15 or via special enrollment — you’ll need to create an account on HealthCare.gov or through your state’s provider. You’ll then complete the application to see plans and pricing and select which option is best for you.
Things you may need while applying:
- for everyone on your application
- Employer and income information for everyone in your household
- Current health insurance policy numbers (if applicable)
- Information about health insurance available from your employer
- Immigration documentation
Again, after you’re enrolled, your plan should start the first of the month following your enrollment date, assuming that you’ve paid your first month’s premium.
Keep an eye out for your insurance card in the mail after you enroll, as well as any other information about the health care plan you chose.
For more health care information, here’s. Also, here’s how to find out if your and the for at-home doctor visits.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.