ACA Marketplace Health Insurance
Comprehensive coverage with subsidies available based on your income. No denial for pre-existing conditions. Enroll with the help of a licensed advisor at no cost to you.
What Is an ACA Marketplace Plan?
The Affordable Care Act (ACA) created a marketplace where Americans can shop for health insurance with consumer protections and income-based subsidies.
Key Protections Under the ACA
- Cannot be denied coverage for pre-existing conditions
- Cannot be charged more due to health history
- 10 essential health benefits required by law
- Free preventive care — no cost to you
- Children can stay on parents' plan until age 26
- Annual out-of-pocket maximum limits your exposure
Do You Qualify for a Subsidy?
Most Americans who enroll through the marketplace qualify for a premium tax credit that reduces their monthly cost — sometimes to $0/month.
- Income between 100%–400% of Federal Poverty Level
- Extended subsidies available above 400% FPL
- Not eligible for affordable employer coverage
- Not eligible for Medicare or Medicaid
ACA Metal Plan Tiers
ACA plans come in four metal tiers. The tier affects your monthly premium and out-of-pocket costs — not the quality of care.
Not sure which tier is right for you? A licensed advisor can compare your options side by side — free of charge.
ACA Subsidies & Cost Assistance
There are two types of financial assistance available for ACA marketplace plans.
Premium Tax Credits
Reduces your monthly premium. Based on your income and household size. Applied directly to your plan so you pay less each month.
| Household Size | ~100% FPL | ~400% FPL |
|---|---|---|
| 1 person | $15,060 | $60,240 |
| 2 people | $20,440 | $81,760 |
| 4 people | $31,200 | $124,800 |
2025 estimates. Exact amounts vary by state and plan.
Cost Sharing Reductions (CSRs)
Reduces your deductible, copays, and out-of-pocket maximum. Only available on Silver plans. Income must be between 100%–250% of FPL.
- Lower deductibles — sometimes as low as $0
- Reduced copays for doctor visits and prescriptions
- Lower out-of-pocket maximum
- Must choose a Silver plan to receive CSRs
- Can significantly reduce your total healthcare costs
If your income is under 250% FPL, a Silver plan with CSRs is almost always the best value.
ACA Enrollment Periods
You can only enroll in ACA marketplace plans during specific windows — unless you qualify for a Special Enrollment Period.
Open Enrollment
November 1 – January 15 each year. Anyone can enroll or switch plans during this period. Coverage starts January 1 or February 1 depending on when you enroll.
Special Enrollment Period
Outside Open Enrollment, you may qualify if you lost coverage, moved, got married, had a baby, or experienced another qualifying life event. You have 60 days to enroll.
Medicaid & CHIP
If your income qualifies for Medicaid or CHIP, you can enroll year-round — no enrollment window required. A licensed advisor can check your eligibility instantly.
What ACA Plans Cover
All ACA-compliant plans must cover these 10 essential health benefits.
Outpatient Care
Doctor visits, preventive care, and services you receive without being admitted to a hospital.
Emergency Services
Emergency room visits and urgent care. Covered even if you go out of network in a true emergency.
Hospitalization
Surgery, overnight stays, and inpatient care when you need to be admitted to a hospital.
Maternity & Newborn
Prenatal care, labor, delivery, and newborn care. All covered under ACA-compliant plans.
Mental Health
Mental health and substance use disorder services, including behavioral health treatment.
Prescription Drugs
Covered medications from the plan's formulary. Generic drugs typically have the lowest copays.
Rehabilitation
Physical therapy, occupational therapy, speech therapy, and devices to help recovery.
Lab Services
Blood tests, X-rays, and other diagnostic tests ordered by your doctor.
Preventive Care
Annual checkups, vaccines, screenings, and counseling — covered at no cost to you.