What Is The Affordable Care Act?

The Affordable Care Act (ACA) is designed to make guaranteed issue health insurance plans available to everyone. These plans cover preexisting conditions along with a list of essential health benefits that don't change from plan to plan.

For ACA plans, call 1-800-273-8115. Or get a quote to see other health insurance options!

Getting ACA coverage

The ACA has established a yearly Open Enrollment Period for individual health insurance. In most cases, if you want ACA coverage, you must enroll in an ACA-compliant medical plan within that period. However, if you experience a qualifying event outside of that Open Enrollment window, you may be able to enroll during a Special Enrollment Period.

Open Enrollment for 2025 ACA plans

Open Enrollment for 2025 ACA medical insurance plans begins on November 1, 2024.

No qualifying event needed.

Qualifying for a medical insurance premium tax credit

Many who apply for health insurance coverage on the marketplace qualify for premium tax credits that can help lower the costs of getting coverage. The amount you may receive is based on the size of your family and your annual income. You can learn more about tax credits and other ways you might save at Healthcare.gov.

Health insurance coverage and exemptions

When the ACA was first implemented, you could be subject to a federal tax penalty if you weren't covered by a health plan that met or exceeded the ACA’s minimum essential coverage requirements. The federal tax penalty no longer applies. However, state penalties may still apply in some states. Check with a tax advisor in your state for more information.

If you are subject to a state penalty, different kinds of exemptions may apply to your situation: income-related, health coverage-related, group-related, hardship-related and more. If you believe you may be eligible for an exemption, you can learn more at Healthcare.gov about fees and exemptions.

ACA medical insurance plans and preexisting conditions

Preexisting condition limitations have been eliminated from ACA health plans. You can’t be denied ACA health insurance coverage on the basis of a health condition, and you can't be charged a higher premium because of your condition.

Sources for buying health insurance

Your employer – Some employers offer health insurance to their employees at a reduced rate.
Health insurance marketplaces – Marketplaces, or "exchanges," are a way for people to shop for and buy health insurance, which may be referred to as a health plan. Each marketplace is divided between individual (for families and individuals) and SHOP (health plans for small employers) marketplaces.
Health insurance companies – Insurance companies can offer plans directly to people – just as we have done in the past. We can also offer approved plans through the marketplaces.

What types of insurance can cover what ACA medical insurance plans do not?

Even some of the best ACA health plans don't cover everything. You may want to consider a UnitedHealthcare branded supplemental plan for additional coverage. Plans are underwritten by Golden Rule Insurance Company.

Dental insurance can help with the costs of routine cleanings and dental issues
Vision insurance can help pay toward eye exams and prescription eyewear expenses
Accident insurance can assist with surprise medical bills that follow accidental injuries
Fixed indemnity insurance pays set benefits for many covered, common medical services

Coverage for older children

If a health insurance plan covers children, they can be added to or kept on the parent's policy until they turn 26 years old.

Health care reform & existing coverage

Over time, we anticipate further regulations to guide in implementing the health care reform law, and there may be new requirements in individual states as well. We can assure you that our health plans comply with applicable state and federal laws today and will continue to do so as changes take effect.

What about changes to my health plan?

We are committed to communicating with you directly and in a timely manner when your health insurance plan is affected by specific provisions and/or changes in the ACA law.

You can expect to receive written communications from us that explain what changes or additions will be made to your health insurance plan and what they mean for you and your family.

The ACA requires issuers to provide a Summary of Benefits and Coverage.

Also of Interest:

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