The Top 10 Questions About Affordable Care Act Plans Answered

The Top 10 Questions About Affordable Care Act Plans Answered

31 million Americans have health insurance coverage through the Affordable Care Act (ACA).

The ACA brought many changes to health insurance in the United States but many people don’t truly understand their options. Could you be saving money by enrolling in an ACA insurance plan?

Keep reading to learn more about the most common questions about Affordable Care Act plans ahead of the upcoming 2022 enrollment period.

1. What is the Affordable Care Act?

The Affordable Care Act is actually called the Patient Protection and Affordable Care Act (PPACA). It’s usually shortened to the ACA.

The ACA is a law that was designed to make healthcare more affordable for Americans and better protect consumers in the health insurance industry. The ACA also created a marketplace where consumers without health insurance could purchase a plan.

2. How Can the Affordable Care Act Help Me?

The ACA benefits most Americans through its consumer protection measures. The legislation requires insurers to offer certain preventative health services for free and offer a set of predetermined essential benefits under every plan.

The ACA also stops insurance companies from denying coverage because of a pre-existing condition, increasing premiums based on claims, and enforcing annual or lifetime coverage limits. The law has also allowed children to stay on their parent’s insurance until they reach age 26 and expanded Medicaid for low-income adults without children.

3. How Does Affordable Care Act Insurance Work?

The federal government offers subsidized insurance through the marketplace by applying tax credits to monthly premiums, lowering the cost of insurance. Some consumers will also qualify for other benefits that will reduce out-of-pocket costs like deductibles and copays.

4. How Does the Health Insurance Marketplace Work?

The health insurance marketplace is a place where individuals, families, and small businesses can find health insurance, compare plans, and enroll in a policy. It’s also sometimes called the marketplace, the health insurance exchange, and the healthcare marketplace. Many states also have their own version of the health insurance marketplace.

5. Do I Have to Use the Marketplace?

You are not required to use the marketplace. If you have insurance through another channel, such as your employer, you can keep your plan. You can purchase insurance through an agent, broker, or directly from an insurance company.

6. When Can I Enroll in a Plan?

Each year, there is an approximately one-month period called open enrollment where you can purchase a plan. Open Enrollment for 2022 is Monday, November 1, 2021 through Saturday, January 15, 2022.

If you miss this deadline, you can enroll in a plan if you qualify for what is called Special Enrollment. This is the same concept as a qualifying event. The criteria for a qualifying event include:

  • A change in your household such as marriage, death, or having a baby
  • Losing your other health insurance
  • A change in residence such as moving
  • Being released from prison
  • Becoming a U.S. citizen

If you anticipate one of these events occurring, you can request Special Enrollment up to 60 days beforehand. After a qualifying event occurs, you have 60 days to enroll in a marketplace plan. Otherwise, you are locked into your plan until the next open enrollment period begins.

7. How Do Affordable Care Act Plans Work?

Affordable Care Act Plans are divided into four different tiers and named after metals. These include bronze, silver, gold, and platinum plans. These plans are structured based on how much you will pay and how much the plan will pay.

For example, with a silver plan, the plan will pay 70% of the costs and you will pay 30%. With lower tier metals, you will pay more and the plan will pay less. With higher-tier plans, the plan will pay more and you will pay less.

Each tier includes various types of plans, coverages, and insurers.

8. Am I Required to Buy Insurance?

Originally, the Affordable Care Act required individuals to purchase health insurance or pay a penalty. This penalty was eliminated a few years ago.

However, depending on where you live, you may still need to purchase a plan to avoid paying a state penalty. Some states have created their own legislation that includes an individual mandate. You can check with your state or whoever does your taxes to learn more about whether you could face a penalty for not having health insurance.

9. What if I Have Insurance Through My Employer?

Technically, anyone can buy health insurance through the marketplace, even if they qualify for a plan through their employer. The important thing to note is that if your employer offers coverage, you won’t qualify for subsidies or tax credits that lower the cost of a plan.

This means you have to pay full price through the marketplace. Insurance through an employer is usually subsidized by your employer, so you don’t have to pay full price. You likely won’t save any money by going through the marketplace.

The one exception to this rule is if the plans offered by your employer don’t meet the standards set by the Affordable Care Act. Keep in mind that most employers only offer plans that comply with these requirements, so this scenario isn’t likely.

10. What if I Have Medicare?

Medicare is not part of the Affordable Care Act insurance program. This legislation did not affect how Medicare works or how beneficiaries of other federal insurance plans like Tricare and VA benefits get their insurance. If you’re a veteran but don’t have coverage through the VA, you may choose to get insurance through the marketplace.

Are You Looking to Buy Health Insurance?

The best way to find the right health insurance plan for you is by comparing quotes side by side. We can help you find Affordable Care Act plans that work with your health needs as well as your budget.

Click here to compare Obamacare health insurance quotes today to see if you could be saving money on health insurance.