ACA Options and Temporary Insurance

Open Enrollment for 2017 Affordable Care Act (ACA) health coverage started November 1, 2016 and lasts through January 31, 2017. If you enrolled in a health plan by December 19, 2016, your new coverage will start on January 1, 2017.

If you do not purchase or change your healthcare plan during the 3-month open enrollment period, you will not be able to enroll in a new ACA plan for 2017 unless you qualify for an exception. These include Medicaid or the Children’s Health Insurance Program (CHIP) or a Special Enrollment Period (requires a change in life situation).

Here we cover your health insurance options, complete with pros and cons:


  • Enroll in a Marketplace Plan

    The Health Insurance Marketplace is a government-run exchange where companies list their approved health plans.

    If you have a 2016 Marketplace plan and do not change it during this period, it will likely be auto-renewed for 2017.

    All Marketplace plans meet the requirements for minimum essential coverage under the ACA. They are divided into four general benefit categories:

    • Bronze plans offer the lowest premiums but have higher deductibles and cover a lower percentage of health care expenses than other plans.
    • Silver plans are the middle-of-the-road option. They have higher premiums than Bronze plans, but offer lower deductibles and a higher percentage of covered costs.
    • Gold plans have relatively high premiums, but also offer low deductibles and a high percentage of health care expense coverage.
    • Platinum plans have the highest premiums, lowest deductibles, and cover the highest percentage of expenses.


    Important Note:

    Marketplace plans are the only plans that offer two income-based cost-reduction benefits.

    The first is the premium tax credit. This helps lower your monthly premium payments if your income is low enough to qualify.

    The second is the cost-sharing reduction. This benefit reduces the amount of money you have to pay out-of-pocket for health expenses – again, if your income is low enough to qualify. You can only get this benefit if you purchase a Silver plan.

    Pros of a Marketplace Plan:

    • Guaranteed coverage
    • No pre-existing condition exclusions
    • Range of companies & plans to choose from
    • Easy comparison between plans and plan levels
    • Income-based tax credit & cost-sharing reduction


    Cons of a Marketplace Plan:

    • May be expensive
    • Health Maintenance Organization (HMO) plans are much more prevalent than Exclusive Provider Organization (EPO) plans.
      • With an HMO, you pick one primary care physician; a referral is required in order to see another health care professional. With an EPO, you don’t need to choose a primary care physician and you don’t need referrals, but you have a limited network of doctors and hospitals to choose from.
    • Not all insurance companies include their plans in the Marketplace


    A Marketplace Plan Is Ideal for:

    • Individuals who do not have health coverage through an employer
    • Individuals in low-income brackets
    • Families with many dependents
    • Individuals who want a relatively simple insurance shopping experience


    Enroll in a Marketplace plan at healthcare.gov/get-coverage.

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