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Individual and family coverage

ACA health plans made simple.

Marketplace coverage explained in plain language: what every plan has to include, how the metal tiers differ, and whether a premium tax credit could lower your monthly cost.

Compare plans available in your area in minutes.

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Open Enrollment: November 1 to January 15In most states you can enroll or change plans during that window. Miss it and you will need a qualifying life event to enroll. Most people who apply through the marketplace qualify for help paying their premium.

Metal tiers

Four tiers, one set of covered benefits.

Bronze, Silver, Gold, and Platinum all cover the same 10 essential health benefits. What changes is the split between your monthly premium and what you pay when you actually get care.

01Bronze

Lowest monthly premium

Bronze plans are designed to pay about 60 percent of covered costs across a standard population, so you pay the least each month and more when you get care. A fit if you mainly want protection from a large medical bill.

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02Silver

The balanced middle, plus extra savings

Silver plans are designed to pay about 70 percent of covered costs. Silver is also the only tier where cost-sharing reductions apply, which can lower your deductible and copays if your income qualifies.

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03Gold

Higher premium, lower cost at the point of care

Gold plans are designed to pay about 80 percent of covered costs. Worth comparing if you take regular prescriptions, see specialists, or expect a procedure this year.

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04Platinum

Most paid by the plan

Platinum plans are designed to pay about 90 percent of covered costs, with the highest monthly premium and the lowest costs when you use care. Platinum is not offered by every insurer in every county.

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Premium tax credits

See whether you qualify for a $0 monthly premium.

Most people who enroll through the marketplace qualify for a premium tax credit, and for some households that brings the monthly premium down to $0. Eligibility depends on your income, household size, and the plans sold in your county, so the only honest answer comes from checking your own ZIP code. Enter it and you will see real plans with your estimated savings already applied, at no cost and with no obligation to enroll.
Check plans and savings in my areaRead the enrollment FAQs
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What is always covered

The 10 essential health benefits.

Federal law requires every ACA marketplace plan to cover these categories. Preventive services from an in-network provider are covered with no cost sharing, even before you meet your deductible.

  • Ambulatory patient services, meaning outpatient care you get without being admitted to a hospital
  • Emergency services
  • Hospitalization, including surgery and overnight stays
  • Pregnancy, maternity, and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care for children

Dates that matter

Enrollment by the numbers.

Open Enrollment begins in most states
Nov 1
Open Enrollment ends in most states
Jan 15
to enroll after a qualifying life event
60 days
essential health benefits in every plan
10

Good to know

Common questions about ACA coverage.

What is an ACA marketplace plan?
An ACA plan is individual or family health insurance that follows the rules of the Affordable Care Act. Every plan covers the 10 essential health benefits, cannot turn you down or charge you more for a pre-existing condition, and has no annual or lifetime dollar limit on those essential benefits. You buy it yourself rather than getting it through an employer.
When can I enroll in an ACA plan?
Open Enrollment runs from November 1 through January 15 in most states. In most states, if you sign up by December 15 your coverage starts January 1, and if you sign up between December 16 and January 15 your coverage starts February 1. A handful of states run their own marketplace with a different deadline, so check the dates for your state before you decide.
What if I miss Open Enrollment?
You can still enroll if you have a qualifying life event such as losing other coverage, moving to a new area, getting married or divorced, having or adopting a child, or a change in income that affects your eligibility. That opens a Special Enrollment Period, and you generally have 60 days from the event to pick a plan. Medicaid and CHIP have no enrollment window at all: you can apply any time of year.
How do subsidies work?
The premium tax credit lowers what you pay each month for a marketplace plan. Eligibility and the amount depend on your household income, household size, where you live, and the cost of plans in your area. You can take the credit in advance so it is applied to your monthly premium, or claim it when you file your federal tax return. If your income qualifies you for cost-sharing reductions, you have to choose a Silver plan to get them.
What is the difference between Bronze, Silver, Gold, and Platinum?
The metal tiers describe how you and the plan split covered costs, not the quality of care. Bronze plans have the lowest monthly premium and the highest costs when you use care; Platinum is the reverse. All four tiers cover the same 10 essential health benefits, so the choice is mostly about how much care you expect to use and how you would rather pay for it.
Can I be denied coverage for a pre-existing condition?
No. Marketplace plans cannot refuse you, charge you more, or exclude treatment because of a health condition you already have. Premiums can vary only by age, location, family size, tobacco use, and the plan you choose.
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Open Enrollment

See the marketplace plans available in your area.

Enter your ZIP code to compare ACA plans and any savings you qualify for.

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