How to Access Affordable Health Insurance

The Affordable Care Act (ACA), also known as “Obamacare,” has transformed healthcare in America. It has expanded access to health insurance for millions of Americans, making it easier for people to find affordable coverage through the Health Insurance Marketplace.

If you’ve been thinking about getting health insurance but aren’t sure where to start, this guide will walk you through everything you need to know about the ACA and how to enroll in a plan that fits your needs.

Understanding the Health Insurance Marketplace

The Health Insurance Marketplace is a service that helps you shop for and enroll in health insurance plans. It was created as part of the ACA to make insurance more affordable and accessible to those who don’t get it through their job or government programs like Medicaid or Medicare.

Here’s the good news: There’s no income limit for eligibility, so anyone who meets the basic requirements can apply.

Eligibility Requirements: Can You Use the Health Insurance Marketplace?

To enroll in health coverage through the Marketplace, you need to meet the following criteria:

• U.S. Residency: You must live in the United States.
• Citizenship or Immigration Status: You need to be a U.S. citizen, national, or someone who is lawfully present in the country.
• Incarceration Status: You cannot be incarcerated in prison or jail.

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If you meet these conditions, you’re eligible to explore your health insurance options through the Marketplace.

Key Patient Protections Under the ACA

When you sign up for a health plan through the Marketplace, you’re covered by several important protections that ensure you won’t be discriminated against and that you get the care you need.

1. No Discrimination Based on Gender or Pre-existing Conditions

Insurance companies cannot deny you coverage based on your gender or any pre-existing medical conditions. That means whether you have diabetes, asthma, or another condition, you can still get coverage.

2. No Lifetime or Annual Coverage Limits

Before the ACA, some insurance plans would cap the amount of coverage you could receive in a year or over your lifetime. With the ACA, those limits are a thing of the past. You’ll have continuous coverage for essential health benefits like hospital visits, prescription drugs, and preventive care.

3. Young Adults Can Stay on Family Plans

Another ACA benefit allows young adults to remain on their parents’ health insurance plan until they turn 26. This is a game-changer for many young people who are just starting out in their careers and may not have access to employer-sponsored health plans.

Find out if you are eligible for a Health Insurance Marketplace plan

See if you are eligible to use the Health Insurance Marketplace. There is no income limit.

To be eligible to enroll in health coverage through the Marketplace, you:

• Must live in the United States
• Must be a U.S. citizen or national (or be lawfully present). Learn about eligible immigration statuses.
• Cannot be incarcerated in prison or jail

Under the Affordable Care Act (ACA), you have special patient protection when you are insured through the Health Insurance Marketplace:

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• Insurers cannot refuse coverage based on gender or a pre-existing condition.
• There are no lifetime or annual limits on coverage for essential health benefits.
• Young adults can stay on their family’s insurance plan until age 26.

Learn more about your rights under the Affordable Care Act.

The amount you pay for your health insurance may depend on where you live, your income, and the size of your household. Health insurance costs include a premium, which is what you pay for your insurance plan each month. But, if you seek health care services, you may also have to pay out-of-pocket costs. Learn about these out-of-pocket costs, including:

• Deductibles
• Coinsurance
• Copayments

Find out about choosing a health insurance plan and estimate what you may pay per year for coverage.

How to enroll in a Health Insurance Marketplace plan

There is a wide range of Health Insurance Marketplace plans to choose from. They offer coverage for not only medical care but also dental and vision. Find out what services all plans cover and what additional coverage is available.

To get started, go to Healthcare.gov to find your state Health Insurance Marketplace. Each state’s Marketplace has its own enrollment instructions.

During the Marketplace open enrollment period each year, you can:

• Choose a plan for the first time
• Continue in your current plan
• Make changes to your current Marketplace insurance plan
• Choose a new plan to replace your current plan

What’s Covered? Essential Health Benefits

Every health plan offered through the Marketplace must cover a set of essential health benefits. These benefits are designed to ensure you get the care you need for a healthy life. They include:

• Preventive and wellness services
• Emergency services
• Maternity and newborn care
• Mental health and substance abuse services
• Prescription drugs
• Pediatric services

While all Marketplace plans cover these basics, you may also have the option to add extra coverage, like dental or vision care, depending on the plan you choose.

If you experience a life event like moving or having a baby, you may be able to change your coverage during a special enrollment period. You may also qualify for a special enrollment period if your household income is below a certain amount.

The Affordable Care Act has made significant strides in improving access to health insurance, and the Health Insurance Marketplace is a crucial tool for many Americans seeking affordable options. Whether you’re applying for the first time or looking to switch your plan, the Marketplace is there to help you navigate the often confusing world of health insurance.

Remember, health insurance isn’t just about coverage – it’s about giving you the peace of mind that you’ll have access to the care you need when you need it. So, take a few minutes to visit Healthcare.gov, see what options are available in your state, and get the coverage that works for you.

Take control of your health – it’s one of the most important decisions you can make.