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Health Insurance / ACA Plans with EverCare

Navigating the Future With You

Understanding ACA: The Healthcare Reform of the Decade

In 2010, the U.S. introduced a pivotal change in the healthcare landscape: The Affordable Care Act (ACA). ACA’s vision? To grant over 20 million Americans more accessible and better quality healthcare. Whether it’s the federal marketplace or state-administered versions, the ACA opened the doors for many seeking coverage.

Qualities of an ACA-Endorsed Plan

ACA plans are major medical insurances that pass the strictest standards of the ACA Health Insurance Marketplace.

These plans are known to:

Equip you with Essential Health Benefits
Set clear boundaries for cost-sharing such as deductibles and copayments
Stand by those with pre-existing conditions
Say goodbye to annual and lifetime coverage dollar limits
Offer 100% coverage for preventive care, including cancer screenings

The 10 Essential Health Benefits

Your ACA plan ensures:

Prompt emergency services
Comprehensive hospitalization
Quality outpatient services
Care for both maternity and the newborn
Services catering to mental health, behavioral challenges, and substance misuse
Access to prescribed drugs
Rehabilitative and habilitative services
Dependable laboratory services
Pediatric care—covering both oral and vision
Services for preventative wellness and chronic disease management

Beyond the Marketplace: ACA’s Extended Reach

You aren’t limited to the ACA marketplace. Many find their perfect ACA-compliant health insurance directly from insurance providers or through private platforms like eHealth. Moreover, while eHealth provides access to marketplace ACA plans, they also offer health insurance solutions outside the confines of federal and state marketplaces.

Also, be aware of non-ACA-compliant medical plans. These lack several of the perks and protections of ACA plans: Some of them include indemnity plans and short-term insurance policies.

Decoding ACA vs. Non-ACA Plans

Deciding between ACA-compliant health insurance and non-ACA options depends on individual circumstances. For instance, if there’s a short gap before you obtain ACA-compliant group health coverage or Medicare, short-term health insurance might be your interim shield. Reach out to an EverCare advisor if you need help making a decision.

What You Need to Know:

Enrolling in ACA plans is typically restricted to the annual Open Enrollment Period, but life events like marriage or childbirth might qualify you for a Special Enrollment Period.
Premium subsidies and cost-sharing reductions are exclusive to marketplace ACA plans, with reductions only on the Silver plan.
Some states might penalize you for choosing a non-ACA plan, despite the federal removal of individual tax penalties. Always be aware of your state’s stance.
Non-ACA policies, such as short-term plans, provide flexibility in both enrollment and cancellation throughout the year.

Types of ACA Plans

PPOs (Preferred Provider Organization Plans)

These plans offer flexibility in choosing your healthcare providers.

POSs (Point-Of-Service Plans)

They combine features of both PPOs and HMOs and may require referrals for certain medical services.

HMOs (Health Maintenance Organization Plans)

With an emphasis on primary care, these plans might need referrals for specialized services.

EPOs (Exclusive Provider Organization Plans)

They operate without primary care physicians and don’t typically cover out-of-network care unless in emergencies.

EverCare's Promise

As the ACA landscape constantly evolves, EverCare stands firm as your reliable guide. We dedicate ourselves to clarity amidst the complexity, helping you find the health coverage that aligns with your needs. With us, securing the best ACA plan becomes an empowered choice, not a daunting task.

Have Questions?

Click the button below to contact us today and a member of our team will get back to you in the next 24-48 hours to review your coverage and answer any questions you have.