Health Insurance
Health Insurance for Individuals and Families
Looking for a health care plan through the Affordable Care Act (ACA) Marketplace? Secure Health Pro can help you find affordable and reliable coverage that suits your needs. Thanks to the Inflation Reduction Act of 2022, many families now have access to even lower monthly premiums.
What Are ACA Plans?
The Patient Protection and Affordable Care Act (ACA), commonly known as Obamacare, was signed into law in 2010 during President Obama’s administration. The ACA aimed to improve the accessibility, affordability, and quality of health insurance across the United States.
Before the ACA, many Americans struggled to afford or obtain health insurance, especially those with pre-existing medical conditions. The introduction of Obamacare significantly reduced the number of uninsured people in the U.S.
ACA plans are available through the Marketplace or Exchange, providing an alternative to employer-sponsored or private plans. Pre-existing conditions do not prevent enrollment in an ACA plan, and many people receive tax credits and subsidies to help lower their premiums.
Every ACA plan must include the ten Essential Health Benefits (EHBs). These benefits include:
- Hospitalization
- Emergency services
- Ambulatory services
- Prescription drugs
- Maternity and newborn care
- Mental health and substance abuse services
- Lab tests
- Chronic disease management, preventive, and “well” services
- Pediatric dental and vision care
- Rehabilitative services
HMO vs. PPO: Which Insurance Plan Is Right for You?
When choosing health insurance, it’s essential to understand the types of plans available to select the one that best fits your and your family’s needs. Two of the most common plan types are Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs).
HMO Insurance Plans
HMO plans require members to get care within their network of doctors and hospitals. Coverage is only provided for services within the network. You’ll select a primary care physician who will coordinate all your care, including specialist referrals. Typically, premiums and out-of-pocket costs for HMO plans are lower than those for PPO plans.
PPO Insurance Plans
PPO plans also use networks but offer more flexibility. You can receive care outside the network, although it may cost more. There’s no need to choose a primary care physician or obtain referrals to see specialists.
How Much Do ACA Plans Cost?
The Affordable Care Act (ACA) introduced new health insurance options and included provisions to expand Medicaid eligibility, prohibit discrimination based on pre-existing conditions, and provide premium subsidies for individuals and families with limited incomes.
Premium tax credits reduce the cost of insurance plans purchased through the ACA Marketplace. Eligibility for these credits is based on household income, which you’ll provide during the application process to determine if you qualify for subsidies.
You’ll also have deductibles, coinsurance, and copayments, depending on your chosen plan. Plans are categorized into metal tiers: Platinum plans offer the most coverage, followed by Gold, Silver, and Bronze.
When Can I Enroll?
The ACA’s annual open enrollment period runs from November 1 to January 15 in most states. Some states have longer enrollment periods. Enroll by December 15 for coverage to begin on January 1; if you enroll after December 15, coverage starts on February 1.
Many qualify for a Special Enrollment Period due to a sudden life change, allowing enrollment in an ACA plan anytime. Qualifying life events include changes in employment, marriage, divorce, moving, and having a child.
Get Help Choosing Health Insurance
Health insurance can be confusing, but you don’t have to navigate it alone. The independent insurance agents at Secure Health Pro will guide you through the selection process, understanding your health needs and budget.
Even outside Open Enrollment, we can explore ACA health insurance options for you. You may qualify for a Special Enrollment Period and get the coverage you need sooner than expected. Call us today to get started!