Health insurance can be expensive in the US, especially when your company doesn’t provide it. If you’re shopping around for enrollment options this fall, looking at health plans through the Affordable Care Act is a good way to start.
The Affordable Care Act, signed by former President Barack Obama in 2010, 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 — aimed at reducing health care costs. More than 35 million Americans are enrolled in coverage related to the Affordable Care Act, President Joe Biden announced on August 2.
We’ll let you know when open enrollment begins for health plans under the Affordable Care Act and how to sign up at HealthCare.gov. For additional reading, here is the best time.
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 the deductible is met.
Silver: This middle of the road coverage comes with a modest monthly premium. It will cost you more than the Bronze option, but your medical costs 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 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 cost of medical care. Since 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 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 could be the best options for you.
If you are under the age of 30 or have a waiver due to inability to afford health insurance, you may qualify for a Catastrophic plan, which has a very low monthly premium and a very high deductible.
Keep in mind 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 to 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 then answer a few questions to see if you qualify for discounted or full-price coverage. Once you receive an answer, your next step is to fill out an application at either your health insurance marketplace or your state’s marketplace to view plans and rates.
When can you sign up for an Affordable Care Act health care plan?
Open enrollment begins November 1st and runs through January 15th. Outside of these dates, you may qualify for special enrollment. Here’s how you can qualify:
Have you had a life-changing event in the past 60 days: Events include losing health coverage, a change in household income, having a baby, getting married, divorced, moving to a new ZIP code, or if someone in your Marketplace plan dies.
Please note that if you have moved to a new zip code, you must prove that you have had insurance for at least one day in the past 60 days or you will lose coverage in the next 60 days. Also, if you lose your job and decide not to accept Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage, you can still enroll in a Marketplace plan.
Applying for Medicaid or the Children’s Health Insurance Program (CHIP): If you apply for one of these plans, you can always apply for health insurance through the Marketplace.
Other living conditions that could satisfy you:
- You get out of jail
- You just became a US citizen
- You begin or end service with AmeriCorps
- You have obtained membership in a federally recognized tribe or status as a shareholder of the Alaska Native Claims Settlement Act (ANCSA) Corporation
To see if you qualify for special enrollment, follow the steps above at healthcare.gov/screener/. If you qualify, your health care plan will begin on the first of the month after you enroll. For example, if you sign up in August, your coverage will begin on September 1.
How to sign up for a health care plan with the Affordable Care Act
Once you’re ready to enroll — whether that’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 provider. You will then fill out the application to view plans and prices and choose which option is best for you.
Things you may need when applying:
- for everyone in your application
- Employer and income information for everyone in your household
- Current health insurance policy numbers (if applicable)
- Information about health insurance is available from your employer
- Immigration documentation
Again, once you’ve signed up, your plan should start on the first of the month following your sign-up date, provided 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. Also, see how you can find out if you are and for home visits to the doctor.
The information contained in this article is for educational and informational purposes only and is not intended as health advice or medical assistance. Always consult a physician or other qualified health care provider with any questions you may have about a medical condition or health goals.