The rollout of the Affordable Care Act (ACA) marks the most significant transformation of the nation’s health insurance landscape since Medicare took effect in 1965.
The centerpiece of the ACA, statewide insurance exchanges, offer consumers a wide variety of policies from private companies. Although you're not limited to shopping on an exchange, start there to see if you qualify for tax credits or subsidies that reduce deductibles and out-of-pocket costs on coverage purchased there. For more on enrollment and open enrollment periods, see Affordable Care Act and Open Enrollment.
To help you navigate your way through the new system, health-care experts offer these guidelines:
Guidelines
- Find your exchange. If you’re online, visit the federal marketplace website, click "Apply now," and choose your state. You can also call 1-800-318-2596 for contact information to apply by phone or in person.
- Provide information. The exchange will use your Social Security number, employer and income information, and policy number for your current health policy to determine your eligibility for discounts or subsidies under the act.
- Weigh the metals. Plans come in four categories — Bronze, Silver, Gold, and Platinum — based on the percentage of health care costs that insurers pay. The more you pay out of pocket for health care, the less expensive the policy. Low-cost catastrophic plans are also available if you’re under 30 or are suffering financial hardship.
- Compare prices and coverage. Read about what the plans cover and how they work; check the provider networks to make sure that they include your doctors.
- Get help if you need it. Temporary consultants ("navigators") are available to answer questions about and help you sign up for coverage.
Of course, you can always call on our agency’s professionals at any time for complimentary advice in navigating your way safely through this "brave new world." For more detailed information on coverage options and what they may include, see Understanding the Affordable Coverage Act and Health Insurance. If you prefer personal assistance, you can talk to an agent.
Frequently Asked Questions
What is a health insurance exchange?
A health insurance exchange is a marketplace where individuals and families can compare and buy health plans from private insurers, and where eligibility for financial help is determined.
How do I know if I qualify for subsidies?
Subsidy eligibility is based mainly on household income and family size; the exchange uses the information you provide to determine whether you qualify and the amount of assistance.
What do the metal levels (Bronze, Silver, Gold, Platinum) mean?
The metal levels describe how costs are split between insurers and enrollees: Bronze pays less for care but has lower premiums, while Platinum pays more of costs with higher premiums.
Can I keep my current doctor when I switch plans?
Possibly—check each plan’s provider network before enrolling to confirm whether your doctors and preferred facilities are included.