Affordable Care Act

Affordable Care Act Guide

Open Enrollment for Affordable Care Act 2020-2021 (2021 Season) has been extended to May 15 for many states! During the open enrollment, you can sign up for new plans or change your Affordable Care Act plans.

The Affordable Care Act, also known as both ObamaCare and, its official title, the Patient Protection and Affordable Act, was passed on March 23, 2010. On June 28, of 2012, the United States Supreme Court upheld the health care act.

The law requires all Americans, with certain stipulations and exceptions, to have health care by a predetermined date. The goal of the act is to reform health care and ensure that the 45 million uninsured and millions of underinsured citizens of the United States can get affordable and acceptable health care. The act also attempts to decrease the cost of healthcare expenses. The goal to have everyone in the United States covered by 2016.

Affordable Care Act Benefits

With Obama Care, citizens can purchase private insurance, get insurance from their employer program, or take advantage of the individual state Health Insurance Marketplace, if their state has one. The marketplaces each have a window of enrollment, which must be adhered to unless of emergency situations. The deadlines, rules, health providers, and descriptions offered can be found at each marketplace website.

The businessman, who needs to know his obligations, can also find information on the websites. Remember, if you own a business with more than 50 employees, you have specific requirements. There are ten basic benefits, also called Essential Benefits, that the insurance offered at the marketplace should provide:

1. Hospitalization benefits
2. Emergency room care
3. Outpatient care
4. Maternity and newborn baby services
5. Pediatric tests and services
6. Mental health care and addiction treatments
7. Prescription drugs
8. Laboratory services and tests
9. Wellness, chronic disease, and preventive services
10. Rehabilitative equipment and services

Affordable Care Act Plans

There is no dollar cap on the Essential benefits. There is no cap in order to ensure that people get full treatments and do not have to worry about the costs. There is a cap for out-of-pocket costs that a person might have to pay. There are five different levels of benefits. They each have a different level of maximum payment percentage:

Platinum………90% average
Gold…………….80% average
Silver………….70% average
Bronze………..60% average

The different tiers plans offer to you:

1. Employer-sponsored insurance coverage (can include COBRA and retirement insurance coverage)
2. Medicaid Part A coverage
3. Medicare Advantage
6. Coverage for Peace Corps volunteers
7. Refugee Medical assistance
8. Coverage stated on the non-appropriated Fund Health Benefit Program
9. Health care self-funded and offered to by colleges and universities for policy terms starting this year by December 31, 2014
10. Veteran’s health care
11. State high-risk for a policy that will begin on or before December 31, 2014

Enrolling in Affordable Care Act

Each year, there will be an enrollment window. This year that window began on November 1, 2020 and enrollment will close on May 15, 2021. There are year round emergency enrollment options. An emergency would be an event such as pregnancy or loss of your current insurance coverage. You can also apply for government care plans such as CHIP (Children’s Health Insurance Program) and Medicaid throughout the year. For CHIPS enrollment go to your state website. For more information on CHIPS and Medicaid, visit CHIPS will cover such needs as:

• Emergency services
• Routine check-ups and appointments
• Doctor visits
• Immunization
• Needed prescriptions
• Vision and dental care service
• Outpatient and inpatient hospital care
• X-ray and lab services

Before you enroll in a plan, visit your state’s market website. Review all the plans and expenses in your specific state. You will find there will be chat help and frequently answered question options at the state website. Once you are knowledgeable and comfortable with moving ahead, you can begin the process of applying for Obama Care.

Applying for Health Insurance Coverage:

  • Create a marketplace account either by phone (call 1-800-318-2596 for the correct number), in person, or at the market website.
  • The official marketplace website for any state not providing a marketplace is
  • Complete the Affordable Care Act application
  • Pick the desired health plan
  • Enroll in the desired health plan
  • Then contact your new insurance agency and make the plans to remit your first payment

Affordable Care Act Eligibility

The Affordable Care Act website will provide a calculator program where you can determine any benefits you may be eligible for with Affordable Care Act. You may find you can be awarded some benefits, but possibly not all of them. You should have all data and documents ready when you apply. The minimum requirements state that you must be a United Sate’s citizen, qualified immigrant (check, be living in the United States, and not currently be incarcerated.

You will need to have your social security number, legal resident or citizenship documents (if necessary), job information, recent tax forms and filings, and any information on current health care coverage you may have with you as you apply.

Obama Care Timeline
Alabama Affordable Care Act Louisiana Affordable Care Act Oklahoma Affordable Care Act
Alaska Affordable Care Act Maine Affordable Care Act Oregon Affordable Care Act
Arizona Affordable Care Act Maryland Affordable Care Act Pennsylvania Affordable Care Act
Arkansas Affordable Care Act Massachusetts ACA Rhode Island Affordable Care Act
California Affordable Care Act Michigan Affordable Care Act South Carolina ACA
Colorado Affordable Care Act Minnesota Affordable Care Act South Dakota ACA
Connecticut Affordable Care Act Mississippi Affordable Care Act Tennessee Affordable Care Act
Delaware Affordable Care Act Missouri Affordable Care Act Texas Affordable Care Act
District of Columbia Montana Affordable Care Act U.S. Territories ACA
Florida Affordable Care Act Nebraska Affordable Care Act Utah Affordable Care Act
Georgia Affordable Care Act Nevada Affordable Care Act Vermont Affordable Care Act
Hawaii Affordable Care Act New Jersey Affordable Care Act Virginia Affordable Care Act
Idaho Affordable Care Act New Mexico Affordable Care Act Washington Affordable Care Act
Illinois Affordable Care Act New York Affordable Care Act West Virginia Affordable Care Act
Indiana Affordable Care Act North Carolina ACA Wisconsin Affordable Care Act
Iowa Affordable Care Act North Dakota ACA Wyoming Affordable Care Act
Kansas Affordable Care Act New Hampshire ACA
Kentucky Affordable Care Act Ohio Affordable Care Act