For individuals and families
ACA marketplace plans, compared side by side
Marketplace plans can't turn you down for a pre-existing condition, and most people who buy one qualify for a tax credit that lowers the monthly cost. We check what you qualify for, compare the plans sold where you live, and handle the application.
On this page
What ACA coverage includes
Every marketplace plan meets the same floor. Plans differ, but not on whether the basics are covered.
Ten essential health benefits
Hospital and emergency care, prescriptions, maternity and newborn care, mental health, lab work, rehabilitation, children's care, outpatient care and preventive care.
No pre-existing condition exclusions
An insurance company can't refuse you, charge you more or exclude a condition because of your health history.
Preventive care at no cost
In-network checkups, screenings and vaccines are covered without a copay, even before you meet the deductible.
A yearly limit on what you pay
Every plan has an out-of-pocket maximum. Once your in-network costs reach it, the plan pays the rest of covered costs for the year.
Tax credits and savings
The price on a plan is rarely what a household with a tax credit pays. There are two kinds of help, and they work differently.
The premium tax credit
Based on your expected household income and the cost of plans where you live. You can apply it each month to lower your bill.
Cost-sharing reductions
Lower deductibles and copays, only on Silver plans and only at certain incomes. A Bronze plan can look cheaper and cost more over a year.
Estimate your income carefully
The credit is checked against your actual income when you file taxes. Too low and you may repay some; too high and you overpay all year.
Report changes when they happen
A new job, a raise, a marriage or a birth changes the math. Report it promptly and the credit adjusts.
How to choose a plan
Metal tiers describe how costs are split, not the quality of care. Bronze has the lowest premium and the highest deductible; Platinum is the reverse.
Check the network first
The most common regret is a cheaper plan that leaves out your doctor. Check every doctor and hospital against the specific plan.
Check your prescriptions
Plans can price the same drug differently, or not cover it. Bring your medication list, with doses, and we'll check each plan.
Add up the whole year
Twelve months of premiums plus what you're likely to spend on care. That total is the number to compare.
Know what isn't ACA coverage
Short-term plans, fixed indemnity and health-sharing programs can exclude conditions and cap what they pay. We'll tell you if you're looking at one.
Getting started
Do it yourself online, or hand it to us. The price is the same either way.
Have these ready
- ZIP code and date of birth for everyone on the plan
- Your best estimate of this year's household income
- The doctors and hospitals you want to keep
- Your current prescriptions, with doses
Mind the enrollment window
You can enroll during the yearly open enrollment period, or within a short window after a life event such as losing job-based coverage, moving, marriage or a birth. Current dates are on HealthCare.gov (opens in a new tab).
Common questions about ACA plans
Does it cost more to enroll through a broker?
No. Marketplace premiums are filed with the state and are identical whether you enroll through us, directly with the insurance company or on HealthCare.gov. The insurance company pays the broker, which is why our help costs you nothing.
What if I have a pre-existing condition?
It doesn't affect whether you can buy a marketplace plan or what you pay. What matters is which plan you pick, because networks and drug lists vary. That's where the real difference is for someone managing a condition.
What happens if my income changes during the year?
Report it. Your tax credit is based on expected yearly income and is settled when you file taxes, so reporting a change promptly adjusts your monthly credit and avoids a bill at tax time.
Can I keep my doctor?
Only if the plan you choose includes them. Networks differ between plans from the same insurance company and change from year to year. Send us the list and we'll check before you enroll.
I missed open enrollment. Is that it?
Not necessarily. Losing job-based coverage, moving, marriage, divorce, a birth or an adoption opens a special enrollment period. Medicaid and CHIP accept applications all year. Call and we'll work out which applies.
Talk to a licensed broker
Call or send a message. We usually reply within one business day, and calling is faster when it's urgent.
Or email ollie@wellcoveredsolutions.com