ACA HEALTH INSURANCE — INDIVIDUAL & FAMILY COVERAGE
Affordable Care Act coverage for individuals and families.
What is ACA health insurance?
The Affordable Care Act (ACA) established a health insurance marketplace where individuals and families can compare private major medical health plans. ACA-compliant plans include important consumer protections and cover a broad range of health care services.
How does it work?
You can compare plans available in your area based on monthly premium, deductible, provider network, prescription coverage, and other benefits. Depending on household income and eligibility, financial assistance may be available to help lower the cost of coverage.
- Coverage options for individuals and families
- Coverage for essential health benefits such as preventive care, doctor visits, hospital services, and prescriptions
- Pre-existing conditions cannot be used to deny ACA-compliant major medical coverage
- Financial assistance may be available for eligible households
- Enrollment is generally available during Open Enrollment or after certain qualifying life events
Why is health insurance important?
Medical expenses can become significant very quickly. Health insurance can help reduce the financial impact of doctor visits, prescription drugs, emergency care, hospital stays, surgeries, and other covered services. It can also make preventive care and routine treatment easier to access.
How do ACA subsidies work?
When people talk about an ACA “subsidy,” they usually mean the Premium Tax Credit. If you qualify, this tax credit can lower the monthly premium you pay for a Marketplace health plan. Eligibility and the amount of assistance are based on information such as your expected annual household income, household size, and other eligibility factors.
Here’s the basic idea: you estimate your household income for the coverage year when you apply. The Marketplace determines whether you qualify for a premium tax credit and how much. You can generally choose to use all, some, or none of the estimated credit in advance. If you use it in advance, it is paid directly to the insurance company and your monthly premium is reduced.
Your income estimate matters. Marketplace savings are based on your expected income for the year you are getting coverage. If your income or household changes during the year, it is important to update your Marketplace application because the amount of financial assistance you qualify for may change.
What happens at tax time? Advance premium tax credits are reconciled when you file your federal income tax return. The amount used during the year is compared with the amount you actually qualified for based on your final household income and family size. If you used more credit than you ultimately qualified for, you may have to repay some or all of the difference. If you used less than you qualified for, the difference may increase your tax refund or reduce the amount of tax you owe.
There may be another type of savings, too. Some eligible households can qualify for cost-sharing reductions, which can lower deductibles, copayments, coinsurance, and the out-of-pocket maximum. These additional savings are available only when an eligible person enrolls in a Silver Marketplace plan.
Important: subsidy eligibility and amounts vary by household and can change from year to year. Great Nation Insurance can help you review your Marketplace options and understand how estimated income and household information may affect your health insurance costs.
Need help comparing your options? Great Nation Insurance can help explain available ACA plans, premiums, deductibles, provider networks, and enrollment options so you can make a more informed decision.
Request an ACA Health Insurance Quote
Tell us a little about the coverage you need.
Submitting this form does not enroll you in coverage or bind insurance. A licensed agent will contact you to discuss eligibility, available options, enrollment periods, and next steps.
