Health insurance should be simple

We help seniors who are looking for a health care plan through the Affordable Care Act (ACA) Marketplace.

For Individuals and Families

We assist individuals and families in finding affordable, reliable coverage that fits their needs. Thanks to the recent Inflation Reduction Act of 2022, many families can now enjoy even lower monthly premiums.

What Are ACA Plans?

The Patient Protection and Affordable Care Act, commonly known as the ACA or Obamacare, was signed into law in 2010 with the aim of improving accessibility, affordability, and quality of health insurance across the United States. Before the ACA, many Americans struggled to afford or obtain health insurance due to pre-existing medical conditions. The ACA has significantly reduced the number of uninsured people in the U.S.

ACA plans are available on the Marketplace or Exchange. These plans allow individuals and families to enroll in coverage independently of employer-sponsored or private plans. Pre-existing conditions do not prevent enrollment in an ACA plan, and many people receive tax credits and subsidies to lower their premiums.

All ACA plans must include the ten Essential Health Benefits (EHBs), which are:

  • Hospitalization
  • Emergency services
  • Ambulatory services
  • Prescription drugs
  • Maternity and newborn care
  • Mental health and substance abuse services
  • Lab tests
  • Chronic disease management, preventive, and wellness services
  • Pediatric dental and vision care
  • Rehabilitative services

HMO vs PPO: Which Insurance Plan Is Right for You?

Choosing the right health insurance plan is crucial. Two common types of plans are Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs).

What Are ACA Plans?

HMO plans require members to get care within a network of doctors and hospitals. Coverage is only available within this network. Members select a primary care physician who coordinates all their care, including specialist visits. HMO plans typically have lower premiums and out-of-pocket costs than PPO plans.

PPO Insurance Plans:

PPO plans also use networks but offer more flexibility. Members can receive care outside the network, though at a higher cost. There is no need to choose a primary care physician or get referrals to see specialists.

How Much Do ACA Plans Cost?

PPO plans also use networks but offer more flexibility. Members can receive care outside the network, though at a higher cost. There is no need to choose a primary care physician or get referrals to see specialists.

When Can I Enroll?

The ACA has an annual open enrollment period from November 1 to January 15 in most states. Some states have extended enrollment periods. If you enroll by December 15, coverage begins on January 1; if you enroll after December 15, coverage starts on February 1.

Many qualify for a Special Enrollment Period due to life changes such as employment changes, marriage, divorce, moving to a new city, or having a child, allowing enrollment in an ACA plan at any time of the year.

Get Help Choosing Health Insurance

Navigating health insurance can be confusing, but you don’t have to do it alone! The independent agents at J Johnston Insurance are here to guide you, understanding your health needs and budget to find the best options.

Even outside of Open Enrollment, we can explore ACA health insurance options for you. You might qualify for a Special Enrollment Period and get coverage sooner than you think. Call us today to get started!

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DENISE ANDERSON
Founder, J Johnston Insurance
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