ACA Health Insurance Plans

ACA (Affordable Care Act) plans, also called Obamacare, are comprehensive health insurance plans that cannot deny you coverage for pre-existing conditions. If you have diabetes, high blood pressure, cancer history, or any other health issue - you're guaranteed coverage.

These plans meet federal requirements for essential health benefits and may qualify you for government subsidies to lower your monthly premium.

Cannot Deny Pre-Existing Conditions
Diabetes, heart disease, cancer, asthma - doesn't matter. They must cover you at the same rate as healthy people your age.

May Qualify for Subsidies
Government tax credits can drastically reduce your monthly premium. Some families pay $0-50/month after subsidies.

Comprehensive Coverage
All essential health benefits included - doctor visits, hospital stays, prescriptions, maternity, mental health, preventive care.

Out-of-Pocket Maximum
Once you hit your annual maximum, insurance pays 100% for the rest of the year.

Preventive Care at No Cost
Annual checkups, screenings, vaccines covered at 100% before deductible.

ACA plans come in four metal tiers. Higher tier = higher monthly premium but lower costs when you use care.

Bronze Plans
Lowest premiums, highest deductibles ($7,000-$9,000). Good if you're healthy and rarely see doctors.

Silver Plans
Moderate premiums and deductibles ($4,000-$6,000). Most popular choice. Required for Cost-Sharing Reduction subsidies.

Gold Plans
Higher premiums, lower deductibles ($1,000-$3,000). Good if you have regular medical expenses or take expensive medications.

Platinum Plans
Highest premiums, lowest out-of-pocket costs. Best if you have chronic conditions or know you'll use a lot of healthcare.

You may qualify for premium tax credits (subsidies) if:

Your household income is between 100%-400% of Federal Poverty Level

You don't have access to affordable employer coverage

You're not eligible for Medicare or Medicaid

2025 Income Limits for Premium Subsidies:
Individual: $15,060 - $60,240
Family of 2: $20,440 - $81,760
Family of 4: $31,200 - $124,800

Cost-Sharing Reduction subsidies lower your deductibles and copays if your income is under 250% of poverty level. Only available on Silver plans.

All ACA plans cover these essential health benefits:

✓ Doctor visits and specialist care
✓ Hospital stays and surgery
✓ Emergency services
✓ Maternity and newborn care
✓ Prescription drugs
✓ Mental health and substance abuse treatment
✓ Lab tests and imaging
✓ Preventive care and screenings
✓ Pediatric services including dental and vision
✓ Rehabilitation services

HMO (Health Maintenance Organization)

• Lower monthly premiums
• Must use network doctors and hospitals
• Need referrals to see specialists
• No out-of-network coverage except emergencies
• Best if you want lower costs and don't mind network restrictions

PPO (Preferred Provider Organization)

• Higher monthly premiums
• Can see any doctor, in or out of network
• No referrals needed
• Out-of-network coverage available (costs more)
• Best if you want flexibility to choose providers

Open Enrollment: November 1 - January 15 annually
Coverage starts January 1 or February 1 depending on when you enroll.

Special Enrollment Period:
Lost job-based coverage
Got married or divorced
Had a baby or adopted a child
Moved to a new state
Lost other health coverage

You have 60 days from the qualifying event to enroll.

ACA Plan Advantages:

• Cannot deny pre-existing conditions
• May qualify for subsidies
• Comprehensive essential benefits guaranteed
• Out-of-pocket maximum protection
• Preventive care at no cost

Private Plan Advantages:

• Often lower premiums
• Available year-round
• More plan flexibility
• Wider doctor networks on some plans

We'll show you both options and the actual costs side-by-side.

Monthly Premiums (before subsidies):
Individual: $400-$700/month
Family: $1,200-$2,000/month

With subsidies, many families pay: $0-$200/month

Deductibles range: $1,000-$9,000 depending on metal tier

Out-of-Pocket Maximums:
$9,450 individual / $18,900 family (2025 limits)

Your actual costs depend on age, location, tobacco use, household size, and income.

"Will my doctor be in network?"
Depends on the plan. HMO networks are narrower. PPO networks are broader but cost more. We'll check your doctors before you enroll.

"What if I make too much for subsidies?"
You pay full price, which is often expensive. Private plans may be more affordable. We'll compare both for you.

"Can I get coverage if I'm self-employed?"
Yes. ACA plans are designed for people without employer coverage.

"What if I'm between 100%-138% poverty level?"
You may qualify for Medicaid instead, depending on your state. We'll help you determine the best option.

"Do I have to pay the penalty if I don't have insurance?"
The federal penalty was eliminated in 2019. Some states have their own penalties (CA, MA, NJ, RI, VT, DC).

1. Get Your Quote
Call 800-835-1776 or complete online form

2. Check Subsidy Eligibility
We'll calculate your estimated tax credit

3. Compare Plans
See your options across Bronze, Silver, Gold, Platinum tiers

4. Enroll
Complete application during open enrollment or special enrollment period

5. Pay First Premium
Coverage starts on effective date

We handle the entire process and make sure you're getting maximum subsidies.

CALL NOW: 800-835-1776

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