Affordable Healthcare Through the ACA
Under the Affordable Care Act, families of all income levels can find affordable health insurance. This is possible through a number of ways.
Metal Levels of Coverage1
Affordable Care Act plans enable you to choose from four levels of coverage, called metal levels. Each level has a different percentage for how you and your insurance company split the cost of healthcare after you’ve met your deductible. In general, the higher your monthly premiums, the less you’ll pay out of pocket for your health services.
These levels include:
- Bronze: 60% covered by your health insurance provider, 40% covered by you.
- Silver: 70% covered by your health insurance provider, 30% covered by you.
- Gold: 80% covered by your health insurance provider, 20% covered by you.
- Platinum: 90% covered by your health insurance provider, 10% covered by you.
Essential Health Benefits
No matter what type of plan you enroll in, Affordable Care Act plans are required to cover 10 essential health benefits, which include:
- Prescription drugs
- Pediatric services
- Preventive and wellness services, and chronic disease management
- Emergency services
- Mental health and addiction services
- Pregnancy, maternity, and newborn care
- Ambulatory patient services
- Laboratory services
- Rehabilitative and habilitative services and devices
Subsidies to Lower Your Healthcare Costs2
There are subsidy programs available to help lower or even cover the cost of your premiums or out-of-pocket costs if you qualify. They include:
- Premium Tax Credit: Families making between 100% and 400% of the Federal Poverty Level (FPL) can lower or cover the cost of premiums either in direct payment to the health insurance provider, or expensed in the annual tax return. In 2021, eligible income is from $12,760 to $51,040 for an individual and from $26,200 to $104,800 for a family of four. And as of March 2021, the American Rescue Plan Act has expanded the eligibility requirements for premium tax subsidies. You could qualify for a zero-premium silver or bronze health plan.3
- Cost-Sharing Reduction: Families making between 100% and 250% of the FPL can have the health insurance provider lower or cover more out-of-pocket costs when health services are received.
How Do I Get Affordable Care Act Health Insurance?
HealthMarkets can help you find health insurance with an Affordable Care Act plan quickly and easily. We can even help you determine if you’re eligible for a subsidy — all at no cost to you.
Start comparing plans online with HealthMarkets today.
1. U.S. Centers for Medicare and Medicaid Services. Retrieved from https://www.healthcare.gov/choose-a-plan/plans-categories/. Assessed June 28, 2021. | 2. Kaiser Family Foundation. October 2020. Retrieved from https://www.kff.org/health-reform/issue-brief/explaining-health-care-reform-questions-about-health-insurance-subsidies/. | 3. Congress.gov. Retrieved from https://www.congress.gov/bill/117th-congress/house-bill/1319/text#toc-HC2D7943A4CCA49B19DADC8E6CBAACF66 Accessed on June 30, 2021.
Those with incomes between 100% and 150% of the federal poverty level (FPL) may qualify for a zero-dollar premium silver plan (after tax credits). They may also qualify for a zero-dollar premium bronze plan (after tax credits). Cost sharing (deductibles and coinsurance) may vary.