Essential coverage
Visits, emergencies, hospitalization, prescriptions, maternity and mental health are among the essential benefit categories. Check specific services and cost sharing in each plan.
OBAMACARE · ACA · HEALTH INSURANCE
Life changes.
Your coverage can keep up.
For your family, self-employment or a new chapter. Understand what Obamacare covers, how savings are determined and what to check before choosing.
Coverage that connects with your life
Your familyYour doctorsYour budget
ACA
Obamacare is not a single plan.
It is the familiar name for the Affordable Care Act (ACA). The Marketplace lets eligible individuals and families compare insurance from different companies. Plans from the same insurer can have very different networks and costs.
Pre-existing conditions
Marketplace plans cannot reject you or charge more because of a pre-existing condition. Pregnancy is also covered under these protections.
Savings with clear rules
The application evaluates expected household income for the coverage year and other requirements. A careful estimate helps you avoid relying on savings that do not apply to you.
MAKE AN INFORMED CHOICE
The details make the difference.
Choose a topic. Discover what to check before choosing a plan.
Your doctor deserves a closer look.
Check your doctor and hospital in the exact plan network, including the office location. A familiar insurer does not mean all its plans include your providers.
Your treatment is part of the price.
Review covered drugs, cost tiers and participating pharmacies. Ask about prior authorization, quantity limits and step therapy.
A low premium is just the beginning.
The premium keeps coverage active. Deductibles, copays and coinsurance affect what you pay for care. Consider routine visits and an unexpected medical need when comparing annual costs.
Two kinds of help. Different effects.
If eligible, a premium tax credit lowers your premium. Cost-sharing reductions can lower deductibles and other care expenses, but require a Silver plan. They are different benefits.
Bronze, Silver or Gold. Beyond the label.
Categories describe how costs are shared, not the quality of care. Compare the whole plan.
Bronze
Often combines a lower premium with higher costs when you use care. Consider what you could afford during a hospitalization.
Silver
Especially important if you qualify for cost-sharing reductions. Those savings only apply in this category.
Gold
Often has a higher premium and lower patient cost sharing. Compare total costs with your expected use.
YOUR CALENDAR
Timing is part of the decision.
Annual enrollment
Check the dates for your state’s Marketplace and the coverage start date. Allow time to review documents.
Life changes
Losing coverage, having a baby, getting married or certain moves may open a special enrollment period. Requirements and deadlines apply; keep supporting documents.
After enrollment
Report changes in income, address or household members. Confirm your first payment with the insurer and review your card and network before using coverage.
BEFORE YOUR QUOTE
A better first conversation.
Check what you have ready. This list does not save or send information.
Review my options ›0 / 4 ready
Good questions. Clear answers.
Do I have to be unemployed to apply?
No. The Marketplace may also be an option for self-employed people and others without suitable coverage. An offer of job-based insurance can affect eligibility for financial help.
Does last year’s income determine my savings?
The estimate uses expected household income for the coverage year. Include your spouse and tax dependents, even if not everyone needs insurance. Update the application if your situation changes.
Are adult dental and vision included?
Not necessarily. Adult dental and vision are not required essential Marketplace benefits. Some plans offer them, or they may be available separately; review costs and limits.
Can I apply outside annual enrollment?
Possibly, if you qualify for a special enrollment period. A life change alone does not guarantee eligibility: review the event, dates and required documents.
A good choice starts with listening.
We review your situation, doctors and prescriptions. You decide what comes next.
Requesting guidance does not enroll you in a plan. Availability, eligibility, benefits and costs depend on your situation and the plan.
Explore official information
Marketplace coverage ↗Financial help ↗Plan categories ↗Special enrollment ↗