The cost of health insurance in the US can be expensive, especially if your company does not provide it. If you’re looking for options during the enrollment period this fall, checking health plans through the Affordable Care Act is a good way to start.
Signed by President Barack Obama in 2010 and also known as Obamacare, the Affordable Care Act is designed to give more Americans access to affordable health insurance. The law also expands the Medicaid program and supports new methods of providing medical care – such as ACA Health Homes – that aim to reduce health care costs. More than 35 million Americans are enrolled in coverage linked to the Affordable Care Act, President Joe Biden announced on August 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 further reading, here are the best times to do so.
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 meet the requirements of 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 deductible on the Bronze plan is usually much higher than the other options, so you’ll pay more out of pocket until your deductible is met.
silver: This average coverage comes with a moderate monthly premium. This will cost you more than the Bronze option, but your medical expenses will be less than if you choose 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 expenses 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. Because the deductible is so low, your plan will start paying your medical expenses sooner than any other option.
Deciding which plan to choose depends on your lifestyle, how often you will need health care, and what type of medical treatment you need. For example, if you are healthy and expect to use your insurance only for emergencies, you can choose the Bronze or Silver plan. If you are currently receiving treatment or expect to need regular medical care, the Gold and Platinum options may be the best options for you.
If you are under the age of 30 or have an exception due to inability to afford health insurance, you may qualify for a catastrophic plan that 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 may cost less.
How to find out if you’re eligible for an Affordable Care Act plan
Before you start thinking about which plan to choose, you first need to find out if you really 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.
Next, you’ll answer a few questions to see if you’re eligible for discounted or full-price coverage. Once you receive a response, your next step is to fill out an application in the Health Insurance Marketplace or your state’s own marketplace to view plans and rates.
When can you sign up for an Affordable Care Act health plan?
Open enrollment begins November 1st and runs through January 15th. Outside of these dates, you may be eligible for special enrollment. Here’s how you can qualify:
In the last 60 days, you had a life-changing event: Events include loss of health coverage, change in household income, birth of a baby, marriage, divorce, moving to a new zip code, or if someone on your Marketplace plan dies.
Note that if you’ve moved to a new ZIP code, you must show proof that you had coverage for at least one day in the past 60 days or that you will lose coverage in the next 60 days. Also, if you’ve lost your job and decide not to get COBRA (Consolidated Omnibus Act) coverage, you can still enroll in a Marketplace plan.
You are applying for Medicaid or the Children’s Health Insurance Program (CHIP): If you’re applying for one of these programs, you can apply for health insurance through the Marketplace at any time.
Other life circumstances that might qualify you:
- You get out of jail
- You just became a US citizen
- You are starting or ending AmeriCorps service
- You have earned membership in a federally recognized tribe or shareholder status in a corporation under the Alaska Native Claims Settlement Act (ANCSA)
To see if you qualify for special enrollment, follow the steps above at healthcare.gov/screener/. If you’re eligible, your health plan will start on the first of the month after you enroll. For example, if you enroll in August, your coverage will begin on September 1.
How to apply for Obamacare
Once you’re ready to enroll—whether it’s between Nov. 1 and Jan. 15 or through special enrollment—you’ll need to create an account on HealthCare.gov or through your state’s provider. You’ll then fill out the application to view plans and prices and choose which option is best for you.
Things you may need while applying:
- for everyone in your app
- Employer and income information for everyone in your household
- Current health insurance policy numbers (if applicable)
- Health insurance information can be obtained from your employer
- Immigration documentation
Again, once you sign up, your plan must start on the first of the month after your enrollment date, assuming you’ve paid the first month’s premium.
Watch for your insurance card in the mail after you sign up, as well as any other information about the health plan you’ve chosen.
For more information on healthcare, here. Also, here’s how to tell if yours and on for doctor visits at home.
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 care provider with any questions you may have about a medical condition or health goals.