The Affordable Care Act (ACA), sometimes referred to as "Obamacare," is implemented throughout the country through health exchanges with the goal of making medical insurance available to all citizens of the United States. By law, each and every plan offered via the Marketplace must include coverage for the following necessities:
- The emergency service providers
- Services for outpatients and ambulatory patients
- Services oriented toward prevention and wellness
- Care for expectant mothers and newborn infants
- Medical care for children
- Hospitalization
- Services related to therapy
- Prescription drugs
- Services related to laboratories
- Services pertaining to both mental health and substance misuse
Key Takeaways
Cigna, Centene, Anthem, and Molina are among the most prominent insurance providers participating in Obamacare. Because none of these four insurance providers offers Marketplace plans in all fifty states, your choices will be determined by the state in which you now reside. In the Marketplace, companies typically offer tiered plans, and in general, higher-tier plans come with higher monthly premiums but reduce the amount of money you have to pay out of pocket. In the event that you require the services of a specialist, some or all of the associated costs may be covered by your plan; however, you will need a referral from your regular care physician. Depending on the size of your home and the amount of money you bring in each month, you could be eligible for a subsidy that would pay a portion of the premium for the Marketplace plan you select. The following is a list of the most prominent Obamacare insurance providers, followed by an explanation of the various coverage details.1. Cigna
In the states of Arizona, Colorado, Florida, Illinois, Kansas, Missouri, North Carolina, Tennessee, Utah, and Virginia, Cigna is one of the health insurance providers offering plans through the Obamacare exchange. Through the Health Insurance Marketplace, the company provides the following four coverage options: The bronze plan pays 60 percent, and you are responsible for the remaining 40 percent. This is the plan with the lowest possible monthly payment. Silver: The silver plan pays seventy percent, and you are responsible for paying thirty percent. The cost of this plan falls somewhere in the middle. Gold: The gold plan pays eighty percent, and you are responsible for twenty percent of the cost. This is an expensive option to consider. Platinum: The platinum plan will pay 90 percent, and you will be responsible for the remaining 10 percent. This is the most expensive option available. Your plan, the state in which you live, and the medical services that are rendered will each have an impact on the co-pays and deductibles that apply to you. The Cigna summary of benefits and coverage for 2021 includes information about the particular benefits, co-pays, and deductibles that are associated with each plan that is available through the Cigna healthcare exchange.2. Centene (Ambetter)
Centene is an insurance company that is traded on public markets. In 2018, it increased the number of patients it treated through the Obamacare healthcare exchange. Ambetter is a product offered by Centene that serves as the company's health insurance marketplace (HIM). It is currently available in the following states: Arizona, Arkansas, Florida, Georgia, Illinois, Indiana, Kansas, Michigan, Mississippi, Missouri, New Hampshire, New Mexico, Nevada, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, and Washington. Ambetter provides a selection of plans organized into the following three tiers: This plan, known as Ambetter Essential Care (Bronze), has cheaper monthly premiums but greater out-of-pocket costs than the other two options. Ambetter Balanced Care (Silver): A balanced care plan is an excellent option for people who may be qualified to receive financial support from the government in the form of subsidy payments. It strikes a balance between the payments for the premium and the out-of-pocket costs. The Ambetter Secure Care (Gold) plan has the highest monthly premium, but the Ambetter Secure Care (Gold) plan also offers the lowest out-of-pocket costs. Each plan provides coverage for all of the necessary health benefits. Vision and dental care are covered under some policies as well. On the Ambetter website, selecting your state will bring up specific information regarding premiums, deductibles, and co-payments, as well as the specifics of each plan that is offered in each state. This information includes the specifics of each plan.3. Anthem
Anthem is a participant in the health insurance exchanges established by the Affordable Care Act in the following 12 states: Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New Hampshire, Ohio, Virginia, and Wisconsin. However, coverage is only limited in Virginia and Missouri. In Missouri, thirty counties surrounding Kansas City are not included in the coverage (it excludes the Northern Virginia suburbs of Washington, D.C.). These are the four types of plans that are available through the Anthem Healthcare Exchange: Bronze: The plan pays sixty percent, and you are responsible for paying forty percent. Silver: The plan pays for 70 percent, and you are responsible for the remaining 30 percent. Gold: The plan pays eighty percent, and you are responsible for twenty percent. Platinum: The plan pays ninety percent, and you are responsible for ten percent of the cost. The plan selections, deductible, and co-pay amounts will change depending on the state in which you live and the type of plan you have. Simply by entering your ZIP code on the Anthem website, you will have access to a variety of shopping options, including those for individuals and families.4.Molina Healthcare
Molina Healthcare has operations in the healthcare market in 11 states, including California, Florida, Michigan, Mississippi, New Mexico, Ohio, South Carolina, Texas, Utah, Washington, and Wisconsin. Other states in which they operate include New Mexico, South Carolina, Texas, Utah, and Washington. Through the healthcare exchange, it provides the following categories of coverage options: Molina Bronze Plans: These are the most affordable plans. However, they do not include any coverage for preventive care. Molina Silver Plans are low-cost options that provide coverage for urgent care and doctor visits at the lowest possible rates. Molina Gold Plans are plans that have lower prices for items like medical visits and out-of-pocket costs; nevertheless, the premiums for these plans are typically higher. Different plans and states have different requirements for deductibles and copays. You have the ability to view all of Molina's health insurance exchange plans in order to obtain particular plan details.Questions That Are Typically Asked (FAQs)
How can you cancel your insurance through the Marketplace?
You are able to terminate your Health Insurance Marketplace plan online. Before you begin the process of canceling your insurance, you should carefully consider whether or not you are prepared for it to be terminated immediately. If you are, then you can proceed. If it is not a special enrollment period and you do not have a qualifying life event, then it is possible that you will be unable to obtain new health insurance after you have canceled your existing plan.What is the maximum income that qualifies someone for insurance through the Marketplace?
No matter what your income level is, you are able to get health insurance on the Marketplace. The only significant distinction for those with higher incomes is that they will not be eligible for tax credits to assist them in paying for their health insurance payments. Where you live and how many people are in your home both play a role in determining the exact income threshold at which you are no longer eligible for some tax benefits. There is information available online that will assist you in determining whether or not purchasing insurance through the Marketplace would result in cost savings for you.