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ACA/OBAMACARE

ACA-qualifying healthcare coverage is health insurance benefits established to meet the standards set forth by the Affordable Care Act (ACA). These plans cover essential health benefits such as preventive care, hospitalization, prescription drugs, mental health and maternity care.

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Get a Free ACA/OBAMACARE Quote in Minutes!

ACA-qualifying healthcare coverage is health insurance benefits established to meet the standards set forth by the Affordable Care Act (ACA). These plans cover essential health benefits such as preventive care, hospitalization, prescription drugs, mental health and maternity care.

What is ACA/Obamacare Insurance?

What is ACA/Obamacare Insurance?

The Affordable Care Act (ACA), often referred to as “Obamacare,” is a comprehensive healthcare reform law enacted in 2010 aimed at expanding health insurance coverage, reducing healthcare costs, and providing preventive care. The law includes provisions such as the creation of health insurance marketplaces, the expansion of Medicaid, and the establishment of 10 essential health benefits that insurance plans must cover.

Qualifying health insurance coverage, also known as minimum essential coverage, refers to any health insurance plan that meets the standards set by the ACA. Any health insurance plan that does not meet the minimum requirements is not considered a “major medical” plan.

What Does ACA/Obamacare Insurance Cover?

ACA health insurance plans are required to cover the following healthcare services, often referred to as the 10 essential health benefits:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care

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ACA/Obamacare Insurance is Guaranteed Issue

ACA major medical insurance is required under law to be “guaranteed issue.” That means you cannot be denied coverage based on health status (including pre-existing conditions), gender, or other factors.

While health plan coverage is guaranteed regardless of health status, gender or medical history, in some states, you can be charged higher premiums for some things such as age, tobacco use, family size, and geographic location.

Do You Need ACA/Obamacare Insurance?

As of 2019, the ACA individual mandate is no longer being enforced with a federal tax penalty for adults 26 and older who opt out of coverage without qualifying for an exemption. However, some states have individual mandates and tax penalties for going without qualifying coverage.

Do You Need ACA/Obamacare Insurance?

Even though you can’t be penalized under federal law for not having major medical coverage, you may still consider these ACA plans if you:

  • Aren’t already covered on a parent’s or employer’s major medical plan
  • Have a pre-existing condition – major medical plans are guaranteed issue, so you’ll always be able to enroll, and you can’t be charged more because of health conditions you had before the date coverage starts
  • Qualify for a subsidy – you may be able to get an ACA plan at a more affordable rate than you think
  • Rely on prescription drugs – major medical health plans are required to offer drug coverage, and the scope of drugs that they cover could be more expansive than with other non-qualifying health plans.
  • Live in a state with an ACA tax penalty

Frequently Asked Questions Regarding ACA/OBAMACARE

When is open enrollment? open When is open enrollment?
Is Obamacare still in effect, or has it been repealed? open Is Obamacare still in effect, or has it been repealed?
What happens if I don’t have health insurance? open What happens if I don’t have health insurance?
How do I figure out if I qualify for an Obamacare subsidy? open How do I figure out if I qualify for an Obamacare subsidy?
What are my options if I can’t afford major medical health insurance? open What are my options if I can’t afford major medical health insurance?
Where can I buy affordable health insurance? open Where can I buy affordable health insurance?
How do I choose the best health insurance plan? open How do I choose the best health insurance plan?
Where can I find alternative coverage options? open Where can I find alternative coverage options?
When Can You Get ACA/Obamacare Insurance?

When Can You Get ACA/Obamacare Insurance?

Individual major medical coverage can only be obtained during the annual ACA open enrollment period (typically Nov – Dec depending on state rules) unless you qualify for a special enrollment period due to losing your coverage through a qualifying life event like getting married or divorced, moving to a new ZIP code, having a child or losing your job.

Get a no-obligation health insurance quote now, or call (888) 855-6837 to speak with a health insurance agent to discuss your options.

ACA/OBAMACARE Resources

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ACA Minimum Essential Coverage + Qualified Health Plans
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What are the ACA Essential Health Benefits?
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What Preventive Care is Covered by the ACA?
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Qualifying Life Events for an Individual Health Insurance Special Enrollment Period
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ACA Plan Metal Levels: What They Are + How They Work
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ACA Subsidies – Two Ways to Lower Your Insurance Costs
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