Obamacare Plans

ObamaCare (the Affordable Care Act) is a US healthcare reform law that expands and improves access to care and curbs spending through regulations and taxes.​

ObamaCare Health Insurance Plans

There are several important things to consider when you compare Marketplace plans.
  • Plan category: There are 5 categories of Marketplace insurance plans: Bronze, Silver, Gold, Platinum, and Catastrophic. Plans in these categories differ based on how you and the plan share the costs of your care. The categories have nothing to do with the amount or quality of care you get.
  • Monthly premiums: This is the amount you pay your insurance company for your plan, usually monthly, whether you use medical services or not.
  • Out-of-pocket costs: These include the costs you pay before your insurance begins to pay its share (your deductible, copayments, coinsurance, and your out-of-pocket maximum).
  • Type of insurance plan and provider network: Some types of plans allow you to see almost any doctor or health care facility. Others limit your choices to a network of doctors and facilities, or require you to pay more if you use providers outside the network.
  • Benefits: All plans sold through the Marketplace provide the same essential health benefits and cover pre-existing conditions and offer free preventive services. But some plans offer additional benefits.

​Type of plan and provider network

  • There are different types of Marketplace health insurance plans designed to meet different needs. Some types of plans restrict or encourage you to get care from the plan’s network of doctors, hospitals, pharmacies, and other medical service providers. Others pay a greater share of costs for providers outside the plan’s network.

    Types of Marketplace plans

    Depending on how many plans are offered in your area, you may find plans of all or any of these types at each metal level – Bronze, Silver, Gold, and Platinum. There are different types of Catastrophic plans too.

    Some examples of plan types you’ll find in the Marketplace:
  • Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network (except in an emergency).
  • Health Maintenance Organization (HMO): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.
  • Point of Service (POS): A type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans require you to get a referral from your primary care doctor in order to see a specialist.
  • Preferred Provider Organization (PPO): A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost. Get more information on what you should know about provider networks (PDF).

​Learn more about plans you’re considering

To get details about any plan you’re interested in you can view a summary of benefits, a plan brochure, a provider directory, and a list of covered drugs. You’ll find links to all of these when you’re comparing Marketplace plans.

You’ll also find this information when you compare plans and prices before you apply.

If staying with your current doctors is important to you, make sure they're included in the provider directory before enrolling. Call the plan or the provider to be sure.

To learn more about the best ObamaCare plan for you and to learn if you qualify for subsidies contact us today or get a quote now.
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Charlotte, NC 28270
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