What is the Affordable Care Act?
The Affordable Care Act (ACA), also known as Obamacare, is a comprehensive health care reform law enacted in March 2010. It aims to make affordable health insurance available to more people, expand the Medicaid program, and support innovative medical care delivery methods to lower health care costs. Under the ACA, millions of previously uninsured individuals now have access to quality health care.
Open Enrollment is from November 1st to December 15th for January coverage.
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What is the
Affordable Care Act?
The Affordable Care Act (ACA), also known as Obamacare, is a comprehensive health care reform law enacted in March 2010. It aims to make affordable health insurance available to more people, expand the Medicaid program, and support innovative medical care delivery methods to lower health care costs. Under the ACA, millions of previously uninsured individuals now have access to quality health care.
What is the Essential Plan?
The Essential Plan offered through New York State of Health and private carriers expands zero cost health insurance to thousands more individuals who aren't eligible for Medicaid and can't afford the high cost of Health Insurance. It Includes:
$0/month Premium
Dental & Vision Coverage
Gym Reimbursement
Eligibility is limited to those who meet the income eligibility for that year for individuals or families. Eligible residents can join regardless of preexisting conditions.
How Much Income Can I Earn and Qualify for Essential Plan?
To qualify for Essential Plan you must make under the set income eligibility requirements set forth.
The most you can make is determined by New York State and updates each year. The more members in your household who need coverage, the higher your income can be.
1. Visit this page to find this years income eligibility limits
If you Don't Meet the Income Eligibility Requirements
You may still qualify for a subsidy which greatly reduces your monthly premium
Who Qualifies?
To be eligible to enroll in health coverage through the Health Insurance Marketplace, you must:
Live in the United States
Be a U.S. citizen or national (or be lawfully present)
Not be incarcerated
There is no income limit to use the Health Insurance Marketplace. Special patient protections under the ACA ensure that insurers cannot refuse coverage based on gender or a pre-existing condition, there are no lifetime or annual limits on essential health benefits, and young adults can stay on their family's insurance plan until age 26.
How to Enroll in a
Health Insurance
Marketplace Plan
Enrollment in a Health Insurance Marketplace plan can be done during the annual open enrollment period or a special enrollment period triggered by life events like moving or having a baby. Here’s how to get started:
1. Visit this page to find your state's Health Insurance Marketplace.
2. Follow your state’s specific enrollment instructions.
During the enrollment period, you can:
Choose a plan for the first time
Continue with your current plan
Make changes to your current plan
Choose a new plan to replace your current one
Note: If you experience a life event or your household income is below a certain amount, you may qualify for a special enrollment period.
Types of ACA Plans
The Health Insurance Marketplace offers a range of plans categorized into four metal tiers: Bronze, Silver,
Gold, and Platinum. Each tier represents a different level of cost-sharing:
Bronze Plans
Lowest premiums
Highest out-of-pocket costs
Suitable if you want to pay lower premiums but higher costs when you need care
Silver Plans
Moderate premiums and out-of-pocket costs
Eligible for extra savings if you qualify for cost-sharing reductions
Gold Plans
High premiums
Low out-of-pocket costs
Ideal if you expect to need frequent care
Platinum Plans
Highest premiums
Lowest out-of-pocket costs
Best if you need a lot of care and can afford higher monthly premiums
More Options...
Preferred Provider Organization (PPO) Plans
PPO plans offer flexibility in choosing healthcare providers. You can see any in-network provider without a referral, but out-of-network care will cost more.
Point-of-Service (POS) Plans
POS plans combine features of HMO and PPO plans. You need a referral from a primary care physician to see specialists, but you can receive care out-of-network at higher costs.
Health Maintenance Organization (HMO) Plans
HMO plans require you to use in-network providers and get referrals from a primary care physician. These plans typically have lower premiums and out-of-pocket costs.
Exclusive Provider Organization (EPO) Plans
EPO plans only cover in-network care except in emergencies. No referrals are needed to see specialists, making them more flexible than HMOs but without out-of-network benefits.
Types of Plans
The Health Insurance Marketplace offers a range of plans categorized into four metal tiers: Bronze, Silver,
Gold, and Platinum. Each tier represents a different level of cost-sharing:
Bronze Plans
Lowest premiums
Highest out-of-pocket costs
Suitable if you want to pay lower premiums but higher costs when you need care
Silver Plans
Moderate premiums and out-of-pocket costs
Eligible for extra savings if you qualify for cost-sharing reductions
Gold Plans
High premiums
Low out-of-pocket costs
Ideal if you expect to need frequent care
Platinum Plans
Highest premiums
Lowest out-of-pocket costs
Best if you need a lot of care and can afford higher monthly premiums
More Options...
Preferred Provider Organization (PPO) Plans
PPO plans offer flexibility in choosing healthcare providers. You can see any in-network provider without a referral, but out-of-network care will cost more.
Point-of-Service (POS) Plans
POS plans combine features of HMO and PPO plans. You need a referral from a primary care physician to see specialists, but you can receive care out-of-network at higher costs.
Health Maintenance Organization (HMO) Plans
HMO plans require you to use in-network providers and get referrals from a primary care physician. These plans typically have lower premiums and out-of-pocket costs.
Exclusive Provider Organization (EPO) Plans
EPO plans only cover in-network care except in emergencies. No referrals are needed to see specialists, making them more flexible than HMOs but without out-of-network benefits.
More Info
Important Questions
What Should I Budget for Health Insurance?
You should choose the Bronze or Silver plans if you need to save money, or the Gold or Platinum plans if you have a larger budget and expect to need frequent healthcare services.
Can I Work with My Preferred Doctor?
Yes absolutely, but please ensure that your preferred doctors and hospitals are in-network to avoid high out-of-pocket costs.
Prescription Drug Needs
Choose a plan that effectively covers your medication requirements. If you are unsure which plan to choose, you can schedule a free consultation call with one of our experts below.
I Need Help Paying for Health Insurance
Premium subsidies are available for incomes between 100% and 400% of the federal poverty level; you can check your eligibility on the Health Insurance Marketplace.
How do I Sign Up?
For more detailed information and personalized assistance, schedule an appointment with me today. I can guide you through the process, help you understand your options, and ensure you find a plan that meets your needs and budget. Schedule an appointment now to get started on securing your health insurance coverage.
More Info
Important Questions
What Should I Budget for Health Insurance?
You should choose the Bronze or Silver plans if you need to save money, or the Gold or Platinum plans if you have a larger budget and expect to need frequent healthcare services.
Can I Work with My Preferred Doctor?
Yes absolutely, but please ensure that your preferred doctors and hospitals are in-network to avoid high out-of-pocket costs.
Prescription Drug Needs
Choose a plan that effectively covers your medication requirements. If you are unsure which plan to choose, you can schedule a free consultation call with one of our experts below.
I Need Help Paying for Health Insurance
Premium subsidies are available for incomes between 100% and 400% of the federal poverty level; you can check your eligibility on the Health Insurance Marketplace.
How do I Sign Up?
For more detailed information and personalized assistance, schedule an appointment with me today. I can guide you through the process, help you understand your options, and ensure you find a plan that meets your needs and budget. Schedule an appointment now to get started on securing your health insurance coverage.
Looking for a First-Class ACA Consultant?
Looking for a First-Class ACA Consultant?
Enroll Obamacare is committed to serving you at the highest level with all your Healthcare needs.
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Enroll Obamacare is committed to serving you at the highest level with all your Healthcare needs.
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Directories
Legal