ACA Health Insurance
See If You Qualify for a $0 Monthly Premium ACA Health Plan.
Many people are surprised to find they are eligible for an ACA plan with a $0 monthly premium due to government subsidies. Our straightforward self-enrollment process, featuring clear video explanations from our founder, Robert Lewis, can show you your options in minutes.
Common ACA Questions, Answered
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ACA Enrollment Periods
There are two main times you can enroll. The first is the Open Enrollment Period (OEP), which happens every year, typically starting November 1st. This is the time for anyone to sign up for coverage for the next year.
The second is a Special Enrollment Period (SEP). This is a 60-day window you get after a major life event, like losing other health coverage, getting married, or having a baby. This allows you to get coverage outside of the annual OEP.
Qualifying for Financial Help
Financial help, known as a Premium Tax Credit or subsidy, is primarily based on your estimated household income and size for the year you need coverage. Many people are surprised to find they are eligible for assistance that can significantly lower their monthly premium, sometimes to $0.
The only way to know for sure is to complete an application on the Health Insurance Marketplace. The system will determine the amount of financial help you are eligible to receive based on the information you provide.
The "Subsidy Cliff" in 2025
The "subsidy cliff" was a rule that cut off financial help completely if your income went even slightly above a certain limit (400% of the Federal Poverty Level). Thanks to recent legislation, this cliff has been temporarily removed through the end of 2025.
This is very important because it means more people can get help with their premiums right now. However, these enhanced subsidies are scheduled to expire after 2025, which could cause costs to rise for many in 2026 if the law is not extended.
Cost-Sharing Reductions (CSRs)
Cost-Sharing Reductions (CSRs) are a different type of financial help that lowers your out-of-pocket costs, like your deductible and copays. To get these extra savings, you must be eligible based on your income (typically below 250% of the Federal Poverty Level).
Crucially, you must also enroll in a Silver level plan to receive these benefits. This is a very important detail, as it can make a Silver plan a much better value than a Bronze plan for those who qualify.
HMO vs. PPO Plans
This comes down to your choice of doctors. An HMO (Health Maintenance Organization) generally requires you to use doctors, hospitals, and specialists within its specific network to be covered, and you often need a referral from a primary care physician.
A PPO (Preferred Provider Organization) offers more flexibility, allowing you to see both in-network and out-of-network providers, though your costs will usually be lower if you stay in-network. You typically don't need a referral to see a specialist in a PPO.
ACA "Metal Levels"
The metal levels (Bronze, Silver, Gold, Platinum) do not refer to the quality of care. They indicate how you and your plan share costs. A Bronze plan typically has a lower monthly premium but higher out-of-pocket costs, while a Gold plan is the opposite. Silver plans are in the middle and are the only plans eligible for Cost-Sharing Reductions.
For a more detailed breakdown, you can read our full article on this topic.
Taxes and Subsidies
Yes. If you receive an advance Premium Tax Credit to lower your monthly premium, you are required to file a federal income tax return for that year. You will receive a tax form called a 1095-A from the Marketplace.
You will use this form to "reconcile" the credit you received with your final income for the year. It's very important to complete this step to ensure you received the correct amount of financial help and to remain eligible for future assistance.
ACA for the Self-Employed
Yes, absolutely. The ACA Marketplace is a primary source of health coverage for freelancers, gig workers, and the self-employed. If you don't have access to job-based insurance, the Marketplace is designed for you.
When you apply, you will need to estimate your net self-employment income for the year to see what financial help you may qualify for. It's important to report any changes in your income to the Marketplace throughout the year.
If Your Job Offers Insurance
Generally, if you have an offer of health coverage from an employer that is considered "affordable" and provides "minimum value," you are not eligible to receive premium tax credits in the Marketplace.
However, thanks to a fix for the "family glitch," if the cost to cover your family members on your employer's plan is not affordable, your family members may be eligible for subsidies on a Marketplace plan, even if your individual coverage is affordable.
"Essential Health Benefits"
The Affordable Care Act requires that all Marketplace plans cover a set of 10 categories of services. These are known as the "Essential Health Benefits."
This ensures your plan provides comprehensive coverage and includes services like emergency services, hospitalization, prescription drugs, maternity care, and mental health services. This rule means you are protected from plans that have significant gaps in coverage.
The HBEC Difference
Self-Paced Enrollment
You are in control. Use our straightforward online tools to explore your options and enroll on your own schedule, from the comfort of your home.
Step-by-Step Video Explanations:
You're never alone in the process. Our founder, Robert Lewis, provides straightforward video explanations for each step, showing you how to review your options.
A Supportive Process:
Our goal is to provide the information and a supportive framework you need to choose the right coverage for yourself and your family with a full understanding of your decision.
Commitment to Community
We're dedicated to serving our community and helping individuals and families access the healthcare resources they need.
OUR MISSION
Our mission at Health Benefits Enrollment Center is to provide a straightforward and supportive way for you to understand your insurance options. We are committed to offering accurate information and a respectful process, so you can enroll in the right coverage for yourself and your family with a full understanding of your choice.
OUR VALUES
Integrity: We conduct our business with honesty and ethical practices.
Client Focus: Your needs are our priority. We are dedicated to providing a supportive framework and the tools you need to find the right coverage.
Knowledge: We are committed to maintaining a high level of knowledge and professionalism to ensure the information we provide is accurate and helpful.
Your Straightforward Enrollment Starts Here.
Our unique process uses clear video explanations from our founder,
Robert Lewis, to help you understand your choices and enroll online.
