Affordable Care Act (ACA) Frequently Asked Questions

 Most U.S. citizens and lawfully present immigrants are eligible. Income, family size, and state of residence affect your options.

Typically runs from November 1 to January 15. If you miss it, you may qualify for a Special Enrollment Period due to life events like losing coverage, moving, or having a baby.

You can apply online at HealthCare.gov, through a licensed agent (like our team), by phone, or in person. 

These “metal tiers” reflect how costs are shared:

• Bronze: Low premiums, high out-of-pocket costs
• Silver: Moderate premiums and costs
• Gold: High premiums, low out-of-pocket costs

Yes—premium tax credits and cost-sharing reductions are available based on income and household size, 

Yes, until age 26, even if you're married or not living at home, 

You can absolutely use the Marketplace. It’s designed to support freelancers, small business owners, and independent contractors, 

All ACA plans must cover 10 essential health benefits, including preventive care, emergency services, maternity care, mental health, and prescription drugs, 

Look at:

• Monthly premium
• Deductible
• Out-of-pocket maximum
• Covered services
• Provider network

There’s no longer a federal penalty, but some states still have mandates. More importantly, going uninsured can leave you financially vulnerable in a medical emergency, 

False. The ACA expands access to private insurance—it doesn’t replace the private system with government-run care.

False. While subsidies help lower-income families, middle-income individuals and small business owners also benefit from affordable option. 

Outdated. The federal penalty was eliminated in 2019, though some states still have mandates. 

Misleading. Premiums vary by plan and region. Many people—especially those with pre-existing conditions—have seen lower costs thanks to subsidies and protections.

False. It actually added benefits like free preventive services and annual wellness visits for seniors. 

False. Businesses with fewer than 50 full-time employees are not required to offer coverage. In fact, the ACA offers tax credits to help those who choose to .

False. Only lawfully present immigrants are eligible for ACA plans and subsidies .

False. ACA plans must cover emergency care even if it’s out-of-network—no prior approval needed .

Not necessarily. If your doctor is in-network with your chosen plan, you can keep your provider. Many plans offer broad networks. 

False. You can keep existing coverage if it meets ACA standards. The Marketplace is mainly for those without employer-sponsored insurance .