The Affordable Care Act

The Affordable Care Act (ACA) sometimes referred as "ObamaCare" is a law passed in 2010 that provides individuals and families greater access to affordable health insurance options. The ACA has 3 main goals which are to expand access to affordable health insurance to more people, improve the quality of care, and to reduce long-term healthcare spending.

How can the ACA help you?

Individuals and families with low to moderate income can receive premium tax credits to lower monthly costs and cost-sharing reductions to lower out-of-pocket espenses. Most ACA-compliant health plans require coverage to include:

• Preventive doctor visits and Pediatric Care
• Hospitalization
• Pregnancy and newborn care
• Mental health services
• Prescription drugs
• Coverage regardless of gender or a pre-existing condition
• No lifetime or annual limits on coverage
• Young adults to stay on their family's insurance plan until age 26

When to apply

The Open Enrollment Period (OEP) begins every year on November 1st and typically ends on January 15th. During this time anyone who meet the requirements may apply and qualify for health coverage. During the OEP, you can:

• Re-enroll in your current plan
• Choose a plan for the first time
• Choose a new plan to replace your current plan
• Make changes to your existing insurance plan

What if you missed a deadline?

If anyone would want to apply for health coverage or make changes outside of the Open Enrollment Period (OEP), it could only be done under a Special Enrollment Period (SEP). To qualify for a SEP, one of the following criteria must be met:

• Getting married or divorced
• Having a newborn baby or adding a dependent to your family
• Losing other health coverage
• Moving to a new address
• Been denied Medicaid or CHIP
• Household income of less than 150% of the FPL poverty level

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The Affordable Care Act puts you in charge of your health!

Pre-existing conditions covered with no extra cost

No insurance plan can reject you, charge you more, or refuse to pay for any health condition you had before the effective date of coverage

Free preventive care visits

All Marketplace health plans must cover preventive care services without charging you a copay or coinsurance

Reduction of shared costs

Extra savings available that lowers the amount you have to pay for deductibles, copayments, and coinsurance.

No lifetime or annual dollar limits on health coverage

Insurance companies can no longer set a dollar limit on what they can cover for your health care during the entire time you’re enrolled in that plan

What is covered under the ACA

Primary Care Doctor Visits

Mental Health

Hospitalization

Outpatient procedures

Pregnancy

Urgent Care Visits

Presciptions

Specialist Visits