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ACA Coverage

The Affordable Care Act (ACA), also known as Obamacare, is a government-sponsored health insurance program. It was designed to make health insurance affordable and accessible to those who would otherwise have issues obtaining health insurance, as some may either be unable to afford private insurance or not receive health insurance benefits through an employer.

Where Can I Find ACA Plans?

ACA plans are found on the Marketplace or Exchange. These policies are sold as Bronze, Silver, Gold, and Platinum – plans get more extensive coverage in this order (where Platinum plans have the most comprehensive coverage while the Bronze policies are the most basic).

Don’t let pre-existing conditions stop you from searching for plans. ACA plans don’t discriminate based on pre-existing conditions.

When Can I Join?

You can join during the annual enrollment period, which is from November 1 to January 15. However, you can qualify for a special enrollment period after going through an event such as a marriage, divorce, having a child, or getting a new job.

How Much Do ACA Plans Cost?

Not everyone pays the same amount for coverage. The ACA accounts for how much a person is able to afford, which is why this policy is so inclusive. Your rates will be decided by your household income.

Costs are also impacted by the level of coverage you choose. No matter your income level, a Bronze plan will always be cheaper than a Platinum plan. The more extensive your coverage, the more your plan will cost.

What Are The Most Common Policy Types?

There are more than just a single variety of Bronze, Silver, Gold, and Platinum. These correspond to comprehensiveness, but each company has its own way of offering coverage in terms of network and what’s required of policyholders.

The two most common forms of health insurance that companies will offer are Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans.

How Do HMOs Work?

HMOs are less expensive, but are more restrictive. You’ll only get coverage for services that take place within your policy’s network. You’ll also have to choose a primary care physician, and the only way you can get coverage for seeing a specialist is if you get a referral from your primary care physician.

How Do PPOs Work?

PPOs allow for out-of-network coverage, but out-of-network services will cost you more. Instead, you’ll be incentivized to see in-network physicians (this is where the “preferred provider” part of the name comes from), because they will offer the lowest rates.

You won’t have to choose a primary care physician. You can see any specialist you want without having to go through a primary care doctor.

Find The One That’s Right For You

Midwest Medigap gives you honest expertise with fantastic rates and excellent coverage. We’re here to make sure you get the health insurance policy you deserve, so you can focus on the care and not the cost. Call us today at (515) 650-4110. 

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