ACA Insurance

ACA Insurance:

How is Affordable Care Act Insurance Different?

With the signing of the Affordable Care Act (ACA) into law in March of 2010, many people became concerned that the benefits they had enjoyed with traditional health insurance plans would be completely lost under ACA insurance (also commonly referred to as Health Care Reform insurance).  However, now that ACA insurance plans have rolled out under the federal marketplace, most people are realizing that Health Care Reform insurance actually strengthens the best parts of health insurance and eliminates many weaknesses.

As with health insurance offered prior to January 1, 2014, consumers purchasing ACA insurance still have the privilege of obtaining assistance from an experienced insurance agent as they attempt to navigate the sea of available ACA health care plans.  It is comforting to know that it is not necessary to know it all!  Help is available.

The licensed agents at WNC Health Insurance are fully versed in the rules and regulations under the Affordable Care Act (ACA) and can help you find an affordable insurance plan for you and your family!

What Makes ACA Health Care Plans Different:

ACA health care plans are organized into a metallic system (bronze, silver, gold or platinum), providing the consumer with a simple way to compare plans.  Bronze plans tend to have the highest co pays and deductibles, but lowest premiums; they typically pay for 60% of covered medical costs after the deductible is met. Platinum plans, on the other hand, have the lowest co pays and deductibles, but the highest premiums; they typically pay for 90% of covered medical costs after the deductible is met.

There is also one non-metallic plan, known as a “Catastrophic” plan. Catastrophic plans are only available to individuals under 30 years old or who have qualified for “hardship exemptions” because they don’t make enough to afford coverage. These plans cover just three physician visits per year. Other medical benefits are only covered after the plan’s deductible is met, which is generally higher than that of a Bronze plan [1].

Sound confusing? With WNC Health Insurance, shopping for the right amount of protection and comparing prices has never been easier! Simply give us a call or stop by our store.

Also, under ACA insurance, pre-existing conditions are no longer an issue.  For many men and women, this means that affordable health insurance is finally attainable after years of struggling to find coverage due to chronic illnesses or diminished health.  In addition, Affordable Care Act insurance has removed upper limits on coverage so consumers do not hit a benefit ceiling.

Protections are in place under The Affordable Care Act to ensure that health insurance remains affordable. The maximum out-of-pocket healthcare costs for an individual insured by an ACA compliant plan cannot be higher than $6,350 in a coverage year, or $12,700 for a family.

Premiums for insurance purchased through the federal marketplace may also be subsidized through advanced premium tax credits.  This means better insurance at a lower cost for those who qualify.  Checkout this subsidy calculator to see how little you could be paying under The Affordable Care Act!

The new Healthcare Reform Law (a.k.a. ACA) requires insurers to cover a range of recommended preventative services, including screenings for cancer, diabetes, and blood pressure, without additional copays or deductibles [2]. This Improved access to care also allows many young adults who couldn’t get insurance through their job, to stay on their parents’ health insurance plans until they turn 26 years old[2].

Under the ACA, insurance companies must also abide by what is known as the “80/20 Rule,” meaning that they have to spend at least 80% of what you pay for your premium on medical care and quality improvements.  If they don’t, insurers are required to provide rebates to consumers. Since ACA has passed, consumers have received more than $2 billion in rebates from insurance companies [2].

The Affordable Care Act also strengthened the effectiveness of the Medicare program. Nearly 50 million older Americans and Americans with disabilities rely on Medicare each year, and the ACA has made this program stronger by adding new benefits, fighting fraud, and improving the care provided. Part of these efforts include extending the projected life of the Medicare trust fund by 13 years [2].

Bottom line, ACA insurance takes what was offered in traditional health plans and makes it that much better; and for many people, it makes health insurance affordable for the very first time.


[1] “Catastrophic Health Plan”. Health Insurance Marketplace. Web. 24 June 2015. <https://www.healthcare.gov/glossary/catastrophic-health-plan/>.[2] “Health Care That Works For Americans”. The White House. Web. 24 June 2015. <https://www.whitehouse.gov/healthreform/healthcare-overview>