How does the Affordable Care Act help people like me?
If you need coverage, you can use the Marketplace. If you have coverage, you gain new protections. If you don’t have coverage, you may have to pay a fee.
The Marketplace and what’s changing in 2014
Whether you’re uninsured, you’ve been denied coverage in the past, or you just want to explore new options, the Health Insurance Marketplace will give you more choice and control over your health coverage. The Marketplace will operate in all states, so no matter where you live you’ll have access to coverage.
In the Marketplace, you can compare coverage options based on price, benefits, quality, and other features important to you. You can choose the combination of price and benefits that fits your budget and meets your needs.
You can get lower costs on coverage: The Marketplace application will tell you if you’re eligible for a new way to get lower costs on your monthly premiums or out-of-pocket costs for private insurance. You’ll also learn if you can get free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP).
Essential health benefits are covered in the Marketplace: All plans must offer a comprehensive set of essential health benefits including doctor visits, preventive care, hospitalization, prescriptions, and more.
Pre-existing conditions will be covered: Plans won’t be able to deny you coverage or charge you more due to pre-existing health conditions, including a pregnancy or disability.
You can get help in your area: If you need help finding a plan, several kinds of help will be available to give you personalized assistance with the process.
Fees begin: Beginning 2014, most people are required to have health coverage. If they don’t, they may have to pay a fee.
Rights & Protections
The health care law offers new rights, consumer protections, and benefits like free preventive care.
Read our quick guide to find out how the health care law protects you.
Information for people like you
Young Adults
- New coverage options: If you're under age 26, you can be covered on your parent's health insurance plan now if it allows for dependent coverage. If you're under 30, you are eligible for a lower premium "catastrophic" plan through the Marketplace starting in 2014.
- Get more preventive care, for less: Many insurance companies are now required to cover preventive care for free. This includes 15 covered benefits for all adults, 22 for women (including pregnant women), and 26 for children.
- Save money: You may be eligible for lower costs on your monthly premiums for private insurance. You could also be able to save on out-of-pocket costs. You may also be eligible for coverage through Medicaid in your state. Your children might be able to get coverage through the Children’s Health Insurance Program (CHIP). Get the latest information about the Marketplace: Sign up for email or text updates and we’ll let you know about key dates and news about the Marketplace.
Women
- New Coverage Options: In the Marketplace, insurance companies won't be able to deny coverage to women due to pre-existing conditions, like cancer or being pregnant.
- Choose your doctor: In the Marketplace, you can choose from any primary care provider, OB-GYN, or pediatrician in your health plan's network without a referral.
Save money: You may qualify for lower costs on your monthly premiums or out-of-pocket costs for private insurance.
Women can't be charged more for health coverage than men. The Marketplace will also let you know if you qualify for coverage under Medicaid or the Children’s Health Insurance Program (CHIP).
Get more preventive care, for less: Many insurance companies are now required to cover preventive care for free. This includes 22 covered preventive benefits for women like mammograms, well-woman visits, contraception, and more.
4 Things to Know for Pregnant Women
Starting in 2014, health plans can't refuse you coverage or charge you more because you're pregnant.
- Health plans must also cover free preventive care like gestational diabetes screening and breastfeeding support for women and well-baby visits and vaccines for children.
- Essential health benefits such as pregnancy and newborn care, along with vision and dental care for children, will be covered.
Visit InsureKidsNow.gov to learn more about coverage for pregnant women through Medicaid and the Children’s Health Insurance Program (CHIP).
Get the latest information: Visit the Individuals & Families page and sign up for email updates.
Small Businesses
SHOP for the best coverage: Small businesses with generally fewer than 50 employees can get insurance for their employees in the Small Business Healthcare Options Program (SHOP). Find out what you can do to get ready to enroll.
Save money with employer tax credits: If you have fewer than 25 full-time employees, pay average yearly wages below $50,000 per employee, and pay at least 50% of the cost of health care coverage, you may qualify for a small business health care tax credit. Starting in 2014, the only way to get this credit is if you provide your insurance through SHOP. In 2014 the small business tax credit will be 50% of the amount you pay in premiums (35% for non-profits).
Covering employees is optional: No businesses are required to provide health insurance to their employees.
Employer Shared Responsibility payments: If you have at least 50 full-time equivalent employees and don’t offer health insurance that meets certain minimum standards, you may need to make an Employer Shared Responsibility payment.
Get the latest information: Visit the Small Businesses page and sign up for email updates.
Seniors
- Medicare coverage is protected: Under the health care law, your existing Medicare-covered benefits won’t be reduced or taken away. You don't have to replace your Medicare coverage with Marketplace coverage. For questions about Medicare, visit Medicare.gov, call 1-800-MEDICARE or TTY: 1-877-486-2048.
- Save money on drugs: If you're in the prescription drug "donut hole", you'll get more than 50% off when buying Part D-covered brand-name prescription drugs. You save on generics too. The donut hole will be closed completely by 2020.
- Get more preventive care, for less: Under the health care law, Medicare now covers certain preventive services, like mammograms or colonoscopies, without charging you for the Part B coinsurance or deductible. You also can get a free yearly "Wellness" visit.
- The Health Insurance Marketplace: If you're under 65 and don't have Medicare or Medicaid coverage, you can find coverage and pricing options in the Health Insurance Marketplace. You may qualify for savings on your monthly premiums or lower out-of-pocket costs for private insurance.
- Get the latest information: Visit the Individuals & Families page and sign up for email updates.
People with Disabilities
New coverage options: Most insurance plans can no longer deny you coverage or charge you more because you have a disability or pre-existing health condition.
Save money: The health care law expands the Medicaid program to more Americans, including people with disabilities. Medicaid covers many people with disabilities and some adults under age 65 with modest incomes. Besides free or low-cost coverage through Medicaid, you may also be able to save money on your monthly premiums or out-of-pocket costs for private insurance.
Long term care: State Medicaid programs will also be able to offer additional services to help those who need long-term care at home and in the community. To learn more about programs for people with disabilities, visit www.acl.gov.
No more limits: Insurance companies can no longer impose lifetime dollar limits on your coverage. Yearly limits generally will be prohibited for plan and policy years starting in 2014.
Get the latest information: Visit the Individuals & Families page and sign up for email updates.
Families with Children
- New coverage options: You may be able to cover your child, teen, or young adult on your health plan. If you have children under age 26, you can cover them on your plan if your plan allows dependent coverage.
- Get more preventive care, for less: Many insurance companies are now required to cover preventive care for free. This includes 15 covered benefits for all adults, 22 for women (including pregnant women), and 26 for children.
- Get lower costs on coverage: You or your child may qualify now for free or low-cost health coverage through Medicaid and the Children’s Health Insurance Program (CHIP). You and your dependents may also be eligible to get lower costs on your monthly premiums for private insurance. You may also be able to get lower out-of-pocket costs.
- Get the latest information: Sign up for email or text updates and we’ll let you know about key dates and news about the Marketplace.