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.
On the Marketplace or off: What’s right 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!)
A guide to plan levels and costs
Every ACA plan is assigned a metal tier: Platinum, Gold, Silver or Bronze. Metal tiers have nothing to do with the quality of care you receive. They determine how you and your plan split costs.
Platinum*
- Premium: Highest
- Out-of-pocket costs: Lowest
- Deductibles: Lowest
Gold
- Premium: Higher
- Out-of-pocket costs: Lower
- Deductibles: Lower
Silver
- Premium: Moderate
- Out-of-pocket costs: Moderate
- Deductible: Lower than Bronze plans
Bronze
- Premium: Lowest
- Out-of-pocket costs: Highest
- Deductible: Highest
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
Big life change or one coming up?
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Transforming health care, together
Banner|Aetna aims to offer access to more efficient and effective member care at a more affordable cost. We join the right medical professionals with the right technology, so members benefit from quality, personalized health care designed to help them reach their health ambitions.
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