Your guide to Affordable Care Act Marketplace plan terms
If you’re shopping for an ACA Marketplace plan, it may help to have a guide to health insurance terms. From premiums to subsidies, it’s easier to shop for an ACA Marketplace plan that fits your needs when it’s easier to understand. Let’s take a look at some important things to know.
What are ACA Marketplace plans?
ACA Marketplace plans are health care coverage plans that people can buy on their own, rather than through an employer or another government-run program, like Medicare or Medicaid. You may also hear names like Obamacare and Individual & Family Plans. The health care Marketplace (also called the Exchange) is where ACA health care plans are sold.
Understanding ACA health insurance costs
Here are some terms you may need to know to help you better understand your coverage-related costs.
The amount you pay for your ACA health insurance plan every month. The premium amount can vary.
The amount you pay for your covered medical services before your ACA health plan starts to kick in.
The fixed amount you’ll pay for a covered medical service at the time of getting care. The amount can vary depending on the service.
The portion that you’re responsible for paying for a covered medical service.
The maximum amount you’ll have to pay during the policy period (usually a calendar year) before your health insurance starts to cover 100% of the covered amount.
Terms to know to help you save on an ACA Marketplace plan
The money granted by the government to offer health coverage at a reduced cost or even for no cost to low-income individuals.
Includes the facilities, doctors, and providers that are contracted to provide care for you when you have ACA Marketplace health insurance coverage.
Also known as a drug list, this is a list of commonly used medications organized into different cost levels called tiers. These costs are decided by a health insurer.
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