What do and don’t ACA plans do for me?
The ACA levels the field with minimum coverage that includes:
10 essential health benefits plus birth control and breast-feeding coverage
Coverage for preexisting conditions
Tax credits to help people between 100% and 400% of the poverty level.
(Medicaid covers those under 100%)
Coverage under a parent’s plan until age 26
Protection from cancellation for unintentional application errors
No Lifetime or annual limits for essential health benefits
Free coverage of listed preventative care services
Plans can offer benefits beyond the standardized minimum. These will also vary by state and insurer
The ACA has four standardized categories to help you compare different companies and their plans: Bronze, Silver, Gold, and Platinum. The Co-pay decreases from 40% to 10% as the premiums increase. The same principle applies to deductibles and other costs. Within each category insurers may offer different plans and networks, which in turn will limit the availability and/or cost of hospitals and doctors.
Points to remember:
You can get personal help
Virtually all counties have ACA or State Exchanges with plans that qualify for an HSA.
ACA plans (like Medicare) do not cover long-term custodial or nursing care if you are disabled. Also, abortion procedures aren’t included. Typical health insurance policies do not cover elective procedures, off-label drug use, new procedures, vision, dental, hearing, or concierge services. Coverage for these may be included in an employer plan or can be purchased independently.
Caveat for people under 26 – if your parents claim you as a dependent, but you aren’t covered by their health plan, you can get an ACA plan. However, you will not qualify for income-based tax credits.