The Affordable Care Act (ACA), also known as Obamacare, provides health insurance at a lower rate, so people with jobs that don’t offer coverage or were denied private policies due to a pre-existing condition can receive the treatments they need. Individuals and families must re-enroll every year to maintain their coverage. The Open Enrollment Period (OEP) for 2021 begins on November 1, 2020, and ends on December 15, 2020. If you are new to the insurance market, consult the guide below for more information. 

How Does the ACA Work & What Does It Cover? 

The program includes tax credits, also called subsidies, to decrease the price of monthly premiums. It also provides cost-sharing reductions to lower the out-of-pocket costs for copays, deductibles, and coinsurance. The reductions diminish the out-of-pocket maximum, decreasing the amount that policyholders pay for covered health expenses every year. There are also further subsidies that individuals and families can apply for. 

The Affordable Care Act pays insurance companies to keep their deductibles low while preventing them from denying coverage to people with pre-existing conditions. 

While ACA plans vary, they all include essential health benefits. Every plan covers ambulatory, emergency, outpatient, and preventative care. The program also covers hospitalization fees and laboratory services. Treatments for sudden or pre-existing conditions often require medications, which all the plans cover. Wellness services and chronic disease management are also available. 

Those in need of rehabilitative or habilitative services have coverage, which extends to physical and occupational therapy. Coverage also includes treatments for mental health and substance use disorders. 

How Does the ACA Benefit Families?

Family planning services are covered, along with pregnancy, newborn, and pediatric care. 

Parents can have their children up to age 26 on their plans. Insurance companies can’t drop families or place a cap on the amount of insurance they use. 

By law, health insurance companies must spend 80% of the premiums on medical services. If they don’t, policyholders are paid the excess money back via a check. 

What Happens if I Miss the Open Enrollment Period?

People who miss the OEP between November 1, 2020, and December 15, 2020, can apply for short-term coverage. Some people will still qualify for outside of the period under certain conditions. The loss of a job or existing coverage will entitle people to the program even outside of the OEP. Those who move to a new coverage area are also entitled to coverage throughout the year. People who experience a significant family event, such as marriage, birth, divorce, or death, can receive coverage regardless of the OEP. 

The Affordable Care Act provides numerous plans that can benefit you and your loved ones. However, choosing the right plan for your needs can be difficult. The health insurance agents at Dublin Health & Benefit Group, LLC, make the selection process easier. They’ll work with you to find a plan that’s suited to your needs, so you have the coverage you need if the unexpected occurs. For more information on their coverage options, visit their website. If you’re in the Dublin, NH, area, call them at (603) 563-8820 to schedule an appointment.