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Health Insurance, The Affordable Way

What Is the Affordable Care Act (ACA)?

The Patient Protection and Affordable Care Act, referred to as the Affordable Care Act or “ACA” for short, is the health care reform law enacted in March 2010.

The law has 3 primary goals:

  • Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that may lower costs for households with incomes between 100% and 400% of the federal poverty level (FPL).
  • Expand the Medicaid program to cover eligible adults with income below 138% of the FPL. Not all states have expanded their Medicaid programs.
  • Support innovative medical care delivery methods designed to lower the costs of health care generally.

Key Features of the Affordable Care Act

Provisions included in the ACA expand access to insurance, increase consumer protections, emphasize prevention and wellness, improve quality and system performance, expand the health workforce, and curb rising health care costs.

Benefits of Affordable Care Act

1

Expands health care availability to more citizens

2

Prevents insurers from making unreasonable rate increases

3

Individuals with pre-existing health conditions cannot be denied

4

Coverage for additional screenings, immunizations, and preventative care

  • Hospitalization benefits
  • Emergency room care
  • Outpatient care
  • Maternity and newborn baby services
  • Pediatric tests and services
  • Mental health care and addiction treatments
  • Prescription drugs
  • Laboratory services and tests
  • Wellness, chronic disease, and preventive services
  • Rehabilitative equipment and services

When Does the Yearly Enrollment Period on the Marketplace Begin?

The Health Insurance Marketplace is available for new enrollment on November 1st.

Affordable Care Act Plans

There is no dollar cap on the Essential benefits. There is no cap in order to ensure that people get full treatments and do not have to worry about the costs. There is a cap for out-of-pocket costs that a person might have to pay. There are five different levels of benefits.

They each have a different level of maximum payment percentage:

90%

Platinum

80%

Gold

70%

Silver

60%

Bronze

The different tiers plan offers to you:

  • Employer-sponsored insurance coverage
  • Medicaid Part A coverage
  • Medicare Advantage
  • CHIPS
  • TRICARE
  • Coverage for Peace Corps volunteers
  • Refugee Medical assistance
  • Coverage stated on the non-appropriated Fund Health Benefit Program
  • Veteran’s health care

Applying for Health Insurance Coverage:

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