What an ACA plan covers
Every ACA Marketplace plan covers the same ten categories of essential health benefits, so you know the basics are included no matter which plan you choose:
- Doctor visits and outpatient care
- Emergency services
- Hospital stays
- Pregnancy, maternity, and newborn care
- Mental health and substance use disorder services
- Prescription drugs
- Rehabilitation services and devices
- Lab tests
- Preventive care, wellness visits, and chronic disease management
- Pediatric care, including dental and vision for children
ACA plans can’t deny you coverage or charge you more because of a pre-existing condition.
Metal levels: Bronze, Silver, Gold, and Platinum
Marketplace plans are grouped into metal levels that show how you and the plan share costs. Bronze plans have the lowest monthly premiums but higher costs when you get care. Platinum plans have the highest premiums and the lowest costs when you get care. Silver and Gold fall in between. People under 30, and some people with a hardship exemption, may also qualify for a catastrophic plan.
Savings based on your income
Depending on your household size and income, you may qualify for a premium tax credit that lowers your monthly payment. Some households with lower incomes can also get extra savings on deductibles and copays when they choose a Silver plan. Your advisor will check what you qualify for before you compare plans.
Insurers are allowed to charge tobacco users more, so let your advisor know about tobacco use up front to get an accurate quote.
When you can enroll
In states that use HealthCare.gov, Open Enrollment for 2027 coverage runs from November 1, 2026 to January 15, 2027. Enroll by December 15 for coverage that starts January 1. Some states run their own marketplace with different deadlines.
Outside Open Enrollment, you can usually enroll within 60 days of a qualifying life event, such as losing job-based coverage, moving, getting married, or having a baby.
How we help
Your advisor compares Marketplace plans from multiple carriers, checks that your doctors and prescriptions are covered where possible, applies any savings you qualify for, and helps you enroll. After you enroll, we stay available for questions, renewals, and life changes. There is no cost to use our service.
Common questions
Is Obamacare the same as the ACA?
Yes. Obamacare is a common name for health plans created under the Affordable Care Act and sold through the Health Insurance Marketplace.
Can I be turned down for a pre-existing condition?
No. ACA plans can’t deny coverage or charge you more because of a pre-existing condition.
Does it cost more to enroll through an agent?
No. Licensed agents are paid by the insurance carrier, so your premium is the same as enrolling on your own.