Affordable Care Act Healthcare Plans

What is the Affordable Care Act?

The Affordable Care Act (ACA) was introduced in 2010 as an improvement to the American healthcare system, making it more accessible, affordable, and fair. By expanding coverage, protecting individuals with pre-existing conditions, and emphasizing preventive care, the Affordable Care Act has improved the health and well-being of millions of Americans. In 2024, new enhancements such as expanded tele-health services, increased subsidies, a stronger focus on mental health, and health equity initiatives ensure that the ACA continues to evolve to meet the needs of the American people.

Learn more about the ACA here.

What is the Marketplace?

The Health Insurance Marketplace, created by the Affordable Care Act, is an online platform where individuals, families, and small businesses can shop for and enroll in affordable health insurance plans. The Marketplace offers a range of insurance plans that must cover 10 essential health benefits, including prescription drugs, emergency services, and mental health care. Additionally, the Marketplace ensures that individuals with pre-existing conditions can obtain coverage without facing higher premiums or denial. Subsidies and cost-sharing reductions are available through the Marketplace to help lower the cost of insurance for eligible consumers, making healthcare more accessible to a wider population. CMS.gov,  Center for American Progress

All Marketplace plans cover:

  • 10 essential health benefits, including prescription drugs, emergency services, hospitalization, laboratory services, and mental health and substance use disorder services
  • Free preventive health services at no cost to you when delivered by a doctor or provider in your plan
  • Coverage for pre-existing conditions

What are the Metal Levels?

Health insurance plans available through the Marketplace are categorized into five metal levels: Bronze, Expanded Bronze, Silver, Gold, and Platinum. These levels help consumers understand how costs are shared between them and the insurance company. Each metal level plan offers the same essential health benefits, but the difference lies in how you and the plan share the costs.

The Bronze Plan

The Standard Bronze plans generally have the lowest monthly premiums but the highest out-of-pocket costs when you need care. They cover about 60% of healthcare costs, meaning you’ll pay around 40% of costs out-of-pocket. Bronze plans are ideal if you want a low-cost way to protect yourself from very high medical bills.

Bronze Plan

The Expanded Bronze Plan

The Expanded Bronze plan is a variation of the standard Bronze plan available through the Health Insurance Marketplace. While a typical Bronze plan covers about 60% of healthcare costs, an Expanded Bronze plan covers slightly more—between 60% and 65% of costs. These plans often include some limited coverage for benefits before the deductible is met, such as primary care visits, specialist visits, or generic drugs. This can make Expanded Bronze plans more attractive to consumers who want a lower premium but also some upfront coverage for essential services.However, Expanded Bronze plans are not available in all state marketplaces. Their availability depends on state regulations and the specific offerings of insurers in each marketplace.

Expanded Bronze Plan

The Silver Plan

Silver plans have moderate monthly premiums and out-of-pocket costs. They cover approximately 70% of healthcare expenses, with you paying about 30%. Silver plans are also the only plans eligible for cost-sharing reductions if your income qualifies, which can lower your out-of-pocket costs significantly.

Silver Plan

The Gold Plan

Gold plans have higher monthly premiums but lower out-of-pocket costs. They cover about 80% of your healthcare expenses, leaving you to pay around 20%. These plans are a good choice if you expect to use a lot of healthcare services.

Gold Plan

The Platinum Plan

These plans have the highest monthly premiums but the lowest out-of-pocket costs, covering about 90% of healthcare costs. You’ll pay around 10% out-of-pocket. Platinum plans are suitable if you need a lot of care and are willing to pay more upfront for lower costs when you need services.

Platinum Plan

How do I know which plan to choose?

Choosing the plan that best suits your needs can be challenging. That’s why it’s best to work with a professional ACA Marketplace health insurance expert. Here at Obamacare Assistance we have an experienced team of healthcare plan specialists that can help you decide which plan is best for you.

Call (833) 800-0250 for help choosing the best plan for you.