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The Affordable Care Act (ACA), also known as Obamacare, is a comprehensive health reform law enacted in 2010 to expand access to health insurance, protect patients against unfair insurance practices, and reduce healthcare costs. ACA plans are available through the Health Insurance Marketplace and provide essential health benefits, preventive services, and protections for people with pre-existing conditions.
ACA plans are designed to provide affordable health insurance options for individuals, families, and small businesses, with a focus on expanding access to care and protecting consumers from predatory insurance practices.
All ACA plans must cover a core set of services, including outpatient care, emergency services, hospitalization, maternity and newborn care, mental health and substance use treatment, prescription drugs, lab services, preventive and wellness services, and pediatric services.
Insurers cannot deny coverage or charge higher premiums due to pre-existing health conditions. This provision ensures that everyone, regardless of their health history, has access to coverage.
Many individuals and families are eligible for financial assistance to help lower the cost of premiums and out-of-pocket expenses. These subsidies are based on income and household size.
ACA plans are categorized into four metal tiers—Bronze, Silver, Gold, and Platinum. Each tier represents a different balance between premiums and out-of-pocket costs:
ACA plans cover many preventive services at no additional cost to the insured, such as vaccines, screenings, and annual wellness visits.
ACA plans cannot impose annual or lifetime limits on coverage for essential health benefits, ensuring comprehensive care for those with significant health needs.
Young adults can stay on their parents' health insurance plan until age 26.
ACA plans are typically available during an annual open enrollment period, though special enrollment periods are available for qualifying life events such as marriage, childbirth, or loss of other coverage.
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