If you don’t already have health insurance or if you’re interested in switching to a new health insurance plan, you may want to buy a plan on your own through the Affordable Care Act’s Health Insurance Marketplace. Start by learning how health insurance works. Make a list of questions before you choose a health plan. Gather information about your household income and set your budget for health insurance. Learn the difference between different types of plans so you can decide which one is best for you and your family.

The Affordable Care Act made it easier for people without health insurance or looking to switch health insurance plans to find quality, affordable insurance. All health plans sold through Healthcare.gov are offered by private insurance companies and are required to meet minimum requirements.

These ACA-compliant plans are required to cover a comprehensive set of benefits including hospital care, doctor visits, emergency care, prescription drugs, lab services, preventive care and rehabilitative services. Insurers are not allowed to charge more or discriminate against people based on health status, health history or gender. The ACA also allowed children to stay on their parents’ insurance until age 26.

If you don’t already have health insurance or if you’re interested in switching to a new health insurance plan, you may want to buy a plan on your own through the ACA’s Health Insurance Marketplace. Individuals who need coverage and small employers with fewer than 50 full-time employees can purchase coverage through the Marketplace.

The plans sold on the marketplace must provide patient protections including the guarantee of coverage for pre-existing medical conditions and coverage of essential health benefits. In addition, most people qualify for financial assistance to help make their insurance premiums more affordable. The amount of financial assistance depends on income and family size. People with low incomes may qualify for free or very low premiums.

Medicare beneficiaries receive some additional benefits as a result of the ACA, including an annual wellness exam at no cost, no cost-sharing for preventive services and increased discounts on prescription drugs. The ACA does not cut Medicare benefits, increase seniors’ out-of-pocket Medicare costs or deny seniors end-of-life care.

If you have health insurance through your employer, you can continue to get your health insurance through your job. However, if you are not satisfied with your job-based health insurance, you can shop for a plan through our network. Generally, a quality health insurance plan will cost less through your employer than if you buy one on your own.

Out-of-network services are services provided by a doctor, hospital or other provider that does not have a contractual relationship with your health plan. Not all plans cover out-of-network services, but if they do, your share of the cost is usually significantly higher than if the service was provided in network. For example, an HMO plan may not provide any coverage for out-of-network services, except in an emergency. When possible, try to learn whether the doctor or hospital you are visiting is in-network before receiving services.

The No Surprises Act, which went into effect on January 1, 2022 with the American Heart Association’s strong support, provides federal protections for consumers from surprise medical bills. Surprise medical bills are costs incurred when you unknowingly receive care from a provider or facility that is outside your health care plan’s network. Prior to the No Surprises Act, the out-of-network provider or facility could bill you at higher rates for these costs, unless prohibited by state law. The new protections prohibit surprise bills for emergency care. In non-emergency situations, the law requires that patients receive a good-faith estimate of costs and provide advance consent before receiving out-of-network care.

Yes. Federal law requires any health plan providing benefits for emergency services to cover them even if a particular health care provider or hospital is not in your insurance plan’s network. In addition, your plan can’t charge you a copayment or coinsurance on emergency services provided out-of-network that is greater than what it would charge if the services were provided in-network. However, in some states that allow balance or surprise billing, an out-of-network provider can charge you the difference between what the insurance company has paid and what the provider has charged. In this case, you may face higher out-of-pocket costs for emergency care.