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ACA individual & family plan basics

Wondering what ACA plans cover or which plan is right for you? Here’s a simple guide to help you with the next steps. 

A guide to plan levels and costs

Every ACA plan is assigned a metal tier: Platinum, Gold, Silver or Bronze. All plans offer the same quality of care. The metal tier is based on how you and your plan split the costs. 

 

On the Marketplace or off?

Helping you choose the right plan for you

 

On-Marketplace plan

 

You can choose to buy this type of plan using the help of a broker, through companies with direct enrollment sites (like us), or on the Health Insurance Marketplace® (aka “exchange”). This is where individuals and families can compare and shop for health plans. It is run by either the federal or state government depending on where you live.

 

Great choice if:

You qualify for premium discounts or extra savings on your out-of-pocket costs based on your household income.

 
 

Off-Marketplace plan

 

You can buy this type of plan directly through a broker or health insurance company (like us) outside of the official Marketplace (aka “off exchange”). These plans don’t offer premium discounts or extra savings. But you may find additional plan choices.

 

Great choice if:

You make too much money to qualify for financial help. (Tip: Many people think they won’t qualify, but actually do!)

Coverage for all your health care needs Every ACA plan covers 10 essential benefits

 
  • Prescription drugs
  • Pregnancy, maternity and newborn care
  • Pediatric services, including oral and vision care
  • Mental health and substance use disorder services
  • Preventive and wellness services, and chronic disease management
  • Laboratory services
  • Emergency services
  • Hospitalization
  • Ambulatory services
  • Rehabilitative and habilitative services and devices
 

Questions? We’re here to help.

 

Get in touch with us

 

Our licensed agents can answer your questions, and help you choose the right plan for your needs.  

Contact us

 

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We’ll share information about our plans and more benefits for you.

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Notes

 

*FOR PLATINUM PLANS: You can find select Platinum plans in California only. In another state? Check out the great features of our Gold, Silver and Bronze plans during Open Enrollment.

Legal notices

Health plans are offered or underwritten or administered by Aetna Health of California Inc., Aetna Health Inc. (Florida), Aetna Health Inc. (Georgia), Aetna Life Insurance Company, Aetna Health of Utah Inc., Aetna Health Inc. (Pennsylvania), or Aetna Health Inc. (Texas) (Aetna). Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health® family of companies.

Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Information is accurate as of the production date; however, it is subject to change.

Health benefits and health insurance plans contain exclusions and limitations.