What is the Affordable Care Act and what does it offer?

The Affordable Care Act(ACA) also referred to as Obama care, is a law that is designed to make guaranteed issue health insurance plans available to everyone. These plans will cover preexisting conditions and provide a list of essential health benefits that do not change from plan to plan. The ACA has created a yearly open enrollment period for individual health insurance. Generally, if you want to be covered under the ACA then you must enroll in an ACA compliant medical plan within that period. However, if there is an offer outside of that open enrollment period then you may be able to enroll in that insurance plan during a special enrollment period. 

People who apply for health insurance coverage on the ACA marketplace qualify for premium tax credits to help lower the costs of getting coverage. The amount of tax credit you receive is usually based on the size of your family and your annual income. 

Where can I buy Insurance?

• Employer- Some employers offer health insurance to their employees at a reduced rate. This is not standard among employers so it is important to ask what benefits you receive with the job you are taking. 

• Health Insurance Marketplaces- Marketplaces are a way for people to shop for and buy health insurance in a centralized location, Each marketplace is divided between individual and SHOP( health plans for small employers) marketplaces. Shopping through the marketplace makes it easier to figure out what you need by comparing it to other similar health plans in the same category. 
• Health Insurance Companies- Insurance companies can offer plans directly as done in the past. They can also offer approved plans through the marketplace to give people more options when choosing health care coverage. 

Essential Benefits

All health insurance plans under the Affordable Care Act provide a basic set of coverages to provide standardization among health plans. These health benefits include: 

• Emergency Services
• Hospitalization
• Laboratory tests
• Maternity and newborn care
• Mental health and substance abuse treatment
• Outpatient care
• Pediatric services including dental and vision care
• Prescription drugs
• Preventative services and management of chronic diseased
• Rehabilitation services

Every health plan in the marketplace will always provide these essential benefits. Most health insurance companies always provide those same benefits but it is still important to ask what comes with the plan. Also, insurers can not deny you health care access if you have a preexisting health condition. 

Costs 

The costs of health insurance under the ACA breaks down based upon the amount of the insurance you pay versus the insurance company pays. 

• Bronze: You pay 40% and the insurer pays 60% of the medical costs

• Silver: You pay 30% and the insurer pays 70 % of the medical costs

• Gold: You pay 20% and the insurer pays 80% of the medical costs
• Platinum: You pay 10% and the insurer pays 90% of the medical costs

Although the premium will go up as you go from bronze to platinum you should always pick your plan based upon the amount of coverage you will need in the future. Most healthy Americans will have enough coverage at bronze and silver where gold and platinum are for Americans who have underlying health conditions or problems.

Takeaways

The Affordable Care Act was put into place to provide cheaper health insurance to the average American. You can find a plan that fits you in your state's government marketplace. There are certain benefits that come standard with all health plans under the Affordable Care Act. Understanding the act may be difficult but it is important to recognize where you can save money on your health insurance plans.