Healthy America - www.healthyamericainsurance.com - 800-964-8331

Affordable Care Act (ACA) Comprehensive Health Plans

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Levels of Coverage - ACA Facts
LEVELS
OF COVERAGE
Essential Health Benefits - ACA Facts
ESSENTIAL
HEALTH BENEFITS
Open Enrollment Dates - ACA Facts
OPEN
ENROLLMENT DATES
Special Enrollment Dates - ACA Facts
SPECIAL
ENROLLMENT DATES

Levels of Coverage for Affordable Care Act (ACA) Plans

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Bronze Level -60%

bronze level

The health insurance plan pays approximately 60% of the average cost of all Essential Health Benefits for an average person.

Silver Level - 70%

silver level

The health insurance plan pays approximately 70% of the average cost of all Essential Health Benefits for an average person.

Gold Level - 80%

GOLD LEVEL

The health insurance plan pays approximately 80% of the average cost of all Essential Health Benefits for an average person.

Platinum Level - 90%

PLATINUM LEVEL

The health insurance plan pays approximately 90% of the average cost of all Essential Health Benefits for an average person.

*This is a brief description of the levels of coverage and is for illustration purposes only. For more details, contact Healthy America at 800.964.8331 or visit Healthcare.gov.
Also available based on qualification, is a catestrophic plan. Learn more at Healthcare.gov

Essential Health Benefits

Essential Health Benefits (EHB) must include items & services within the following 10 categories.
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Essential Benefits - Ambulatory Patient Services such as doctor visits
AMBULATORY PATIENT
SERVICES, SUCH AS
DOCTOR VISITS   
Essential Health Benefits - Hospitalization
HOSPITALIZATION
Essential Health Benefits - Mental Health & Substance use disorder services including behavioral health treatment
MENTAL HEALTH &
SUBSTANCE USE DISORDER
SERVICES, INCLUDING
BEHAVIORAL HEALTH
TREATMENT    
Essential health benefits - Rehabilitiation & Habilitative Services & Devices
REHABILITATIVE &
HABILITATIVE SERVICES
& DEVICES  
Essential Health Benefit - Laboratory Services
LABORATORY SERVICES
Essential Health Benefits-  emergency services
EMERGENCY SERVICES
Essential Health Benefits - Maternity & Newborn care
MATERNITY &
NEWBORN CARE 
Essential Health Benefits - Prescription Drugs
PRESCRIPTION DRUGS
Essential Health Benefits - preventive & wellness services & chronic disease management
PREVENTIVE &
WELLNESS SERVICES &
CHRONIC DISEASE
MANAGEMENT   
Essential Health Benefits - pediatric services (pediatric oral care may be included or offered as part of a stand-alone dental plan)
PEDIATRIC SERVICES
(PEDIATRIC ORAL CARE
MAY BE INCLUDED OR
OFFERED AS PART OF
A STAND-ALONE
DENTAL PLAN)     

Open Enrollment Dates

December 15, 2018 is the last day to enroll for a January 1, 2019 effective date.
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Open Enrollment BEGINS

Open Enrollment Begins on November 1, 2018

November 1, 2018

Open Enrollment ENDS

Open Enrollment Ends December 15, 2018

December 15, 2018

Special Enrollment Exceptions

Special Enrollment Period (SEP) is the time outside of the yearly Open Enrollment Period when you can sign up for health insurance.
 
You qualify for a Special Enrollment Period if you've had certain life events, including: 
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Special Enrollment Exceptions (SEP) - Loss of Health Coverage
LOSS OF HEALTH COVERAGE
Special Enrollment Exceptions (SEP) - Moving
MOVING
Special Enrollment Exceptions (SEP) - Getting Married
GETTING MARRIED
Special Enrollment Exceptions (SEP) - Having a Baby
HAVING A BABY
Special Enrollment Exceptions (SEP) - Adopting a Child
ADOPTING A CHILD

If you qualify for an SEP, you usually have up to 60 days following the event to enroll in a plan. If you miss that window, you have to wait until the next Open Enrollment Period to apply. For more information and specifics and to see if you qualify for a Special Enrollment Period, click on the link below.

MORE ABOUT SPECIAL ENROLLMENT PERIODS

Note: This is a brief description of Special Enrollment Periods and Exceptions. To learn full definitions and qualifications, go to healthcare.gov or use the link above.

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