How Do The Plans Work?

For individuals under age 65 (and their families), health insurance offered through the federal or state marketplace (the “marketplace”) in your region may be a good option to consider. You may recognize these plans as the Affordable Care Act (ACA) plans or “Obamacare.” These plans meet all the requirements of the ACA and offer full-coverage health insurance outside of an employer-sponsored program. Marketplace plans provide benefits for a broad range of health care services, both inpatient and outpatient, and can save you money on routine doctor visits, prescription drugs, preventive care, hospital stays, and more. These plans are available to almost everyone, and you can’t be denied based on pre-existing conditions. Financial assistance may be available. You may qualify for federal tax credits or subsidies to lower your costs. This tax credit is based upon your estimated annual household income and can be used to lower your monthly premium costs.

Your Coverage Options

Four types of health insurance plans are available through the marketplace. The Bronze, Silver, Gold and Platinum health insurance plans and are commonly referred to as the “metallic plans.” These Qualified Health Plans offer varying levels of coverage and out-of-pocket costs. In addition, people under 30 and people with hardship exemptions can buy a "catastrophic" health plan through the marketplace. Catastrophic health plans have a low premium but very high out-of-pocket costs.

The detailed coverage provisions, networks, and premiums will vary by region. By talking to a MyChoice Market benefits advisor, or clicking on the MyChoice Market Medical Coverage link, you can review the plans available in your area, as well as learn if you are eligible for a government subsidy.