Health Insurance Under the Affordable Care Act: How and When to Enroll in 2022

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Health insurance can be expensive in the United States, especially when your company does not provide it. If you’re looking for options during the enrollment period this fall, checking out health plans through the Affordable Care Act is a good place to start.

Signed into law by former President Barack Obama in 2010, the Affordable Care Act was designed to give more Americans access to affordable health insurance. The law also expands the Medicaid program and supports new methods of delivering medical care — such as ACA nursing homes — that aim to reduce health care costs. More than 35 million Americans are enrolled in coverage tied to the Affordable Care Act, President Joe Biden announced Aug. 2.

We’ll tell you when open enrollment begins for health plans under the Affordable Care Act and how to register on HealthCare.gov. For additional reading, here is the best time to start collecting your social security benefits.

What health insurance plans are available under the Affordable Care Act?

The state you live in determines which health care providers you can use, assuming you qualify for the Affordable Care Act (see below). For each plan, you should see Bronze, Silver, Gold, and Platinum options. Here’s a breakdown of how each plan works.

Bronze: You will pay the lowest monthly premium, but you will pay more for care. The Bronze plan’s deductible is usually much higher than other options, so you’ll pay more out of pocket until your deductible is reached.

Silver: This intermediate coverage comes with a moderate monthly premium. It will cost you more than the Bronze option, but your medical treatment costs will be lower than if you opted for the Bronze plan.

Gold: This plan includes a high monthly premium and low costs when you need health care. A low deductible means that the amount of medical costs you pay out of pocket will be much lower than the Bronze and Silver plans.

Platinum: The most expensive monthly premium gives you the lowest costs for medical care. Because the deductible is very low, your plan will start paying your medical bills sooner than any of the other options.

The choice of plan depends on your lifestyle, how often you will need healthcare, and the type of medical treatment you need. For example, if you are in good health and think you only need to use your insurance in an emergency, you can opt for the Bronze or Silver plan. If you are currently undergoing treatment or expect to need regular medical care, the Gold and Platinum options might be the best options for you.

If you are under 30 or have an exemption based on inability to pay health insurance, you may qualify for a Catastrophic plan, which has a very low monthly premium and a very high deductible.

Note that your premium is based on your income, so if you have a lower income, your premium might cost less.

piggy bank placed on scattered $20 bills

Spending more on a premium plan can actually help you save money in the long run.

Sarah Tew/CNET

How to know if you qualify for an Affordable Care Act plan

Before you start thinking about which plan you will choose, you must first know if you really qualify for the Affordable Care Act. Go to healthcare.gov/screener/ and enter your zip code. Depending on where you live, you may be redirected to another website.

You will then need to answer a few questions to determine if you qualify for discounted or full price coverage. Once you get a response, your next step is to fill out an application with the health insurance marketplace or your state’s marketplace to see plans and pricing.

When can you enroll in an Affordable Care Act healthcare plan?

Open registration begins November 1 and continues through January 15. Outside of these dates, you may be eligible for special registration. Here’s how you could qualify:

You have experienced a life-changing event in the past 60 days: Events include losing health coverage, a change in household income, having a baby, getting married, divorcing, moving to a new zip code, or if someone on your Marketplace plan has died.

Note that if you moved to a new postcode, you must provide proof that you had insurance for at least one day in the past 60 days, or you will lose coverage within the next 60 days. Also, if you lost your job and decide not to accept Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage, you can still sign up for a Marketplace plan.

You are applying for Medicaid or the Children’s Health Insurance Program (CHIP): If you apply for one of these programs, you can apply for health insurance through the Marketplace at any time.

Other life circumstances that may qualify you:

  • you get out of jail
  • You have just become a US citizen
  • You begin or end your service in AmeriCorps
  • You became a member of a federally recognized tribe or have shareholder status in the Alaska Native Claims Settlement Act (ANCSA) Corporation

To see if you qualify for special registration, follow the steps above at healthcare.gov/screener/. If you are eligible, your health care plan would start on the first of the month following your enrollment. For example, if you enroll in August, your coverage will begin September 1.

crumpled crumpled dollar bill

A change in household income may qualify you for special registration.

James Martin/CNET

How to Apply for a Health Care Plan Under the Affordable Care Act

Once you’re ready to register — whether between Nov. 1 and Jan. 15 or through special registration — you’ll need to create an account at HealthCare.gov or through your state’s provider. You’ll then complete the application to see plans and pricing and select the option that’s right for you.

Things you might need when applying:

  • Social security numbers for everyone on your app
  • Employer and income information for all members of your household
  • Current health insurance policy numbers (if applicable)
  • Health insurance information available from your employer
  • Immigration documents

Again, after you sign up, your plan should start on the first of the month following your signup date, assuming you’ve paid your first month’s premium.

Keep an eye on your Medicare card in the mail after you sign up, along with any other information about the health plan you’ve chosen.

For more information on health care, here how the lack of COVID funding is affecting Americans without health insurance. Here is also how to know if your health insurance covers online therapy and the best telemedicine services for home doctor visits.

The information in this article is for educational and informational purposes only and is not intended to constitute medical or health advice. Always consult a physician or other qualified health care provider with any questions you may have about a medical condition or health goals.

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