Marketplace (ACA)

Marketplace (ACA)

Before the 2010 Affordable Care Act was passed, health insurance companies were able to deny coverage to people due to their current health condition. In addition to introducing new regulations for health insurance companies, this policy also established a marketplace where uninsured Americans can purchase affordable health care coverage.

There are many different health insurance marketplaces, but the largest is the federal exchange that is open to all Americans. If you need insurance coverage and are looking for a Marketplace plan, here is what you need to know to get started.

The Affordable Care Act

The Affordable Care Act, also commonly referred to as Obamacare, instructed states to set up exchanges where individuals and families can find health care coverage that isn’t provided through an employer. While some states have decided not to develop their own exchanges, all of the states are participants in the federal insurance exchange, or Marketplace.

Marketplace Plan Benefits

All Marketplace plans must follow standardized rules that require insurance providers to offer a set of at least ten benefits in all of their plans. The required benefits are as follows:

  • Emergency Services 
  • Hospitalization
  • Laboratory Diagnostic Services
  • Mental Health Care
  • Pregnancy, Maternity, and Newborn Care
  • Preventive health care services
  • Pediatric Services
  • Rehabilitative and Habilitative Services
  • Ambulatory Patient Services
  • Prescription Medications

The Insurance Marketplace

The Marketplace creates competition between insurance providers, as it provides consumers with the opportunity to review all of their insurance options to find the best plan for their situation. The Marketplace is broken down into four different metal tiers, each representing a different level of coverage and costs. The four tiers are bronze, silver, gold, and platinum, ordered from narrowest to broadest coverage.

Marketplace Insurance Comparison

Bronze tier Marketplace plans offer the bare minimum level of coverage, while platinum plans may cover as much as 90% of all health expenses. Which plan is right for you will depend on your location, financial situation, and overall needs. To find out which Marketplace plan is most suitable for you, get in touch with an experienced insurance professional.

Save On Coverage

If you meet certain criteria, you may qualify for discounts that can be applied to your Marketplace policy. These discounts are called premium tax credits, and they are awarded to people whose income falls below a certain threshold. In addition to these premium tax credits, you may also be granted assistance with paying out-of-pocket health care costs, like coinsurance, copayments, and deductibles.

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Marketplace Plans In Your Area

Marketplace plans vary from region to region, so make sure you shop with the help of a skilled advisor. The Medicare experts at Texas Medicare Advisors are prepared to help you find insurance today. Just give us a call at 512-900-3008 to get started with a free quote.