The Affordable Care Act incorporated cost-saving initiatives such as premium tax credits and cost-sharing reductions in an effort to cut the cost of health insurance coverage for individuals. If qualified for them, the premium tax credits helped to cut the monthly health insurance expense. Cost-sharing reductions, on the other hand, were intended to reduce copayments, deductibles, and coinsurance costs. It also contributed to a reduction in the annual out-of-pocket maximum for health spending.

In order to be marketed on the Health Insurance Marketplace, a health insurance plan must have the following essential health benefits:

 

• Childcare services

• Mental wellness and substance use disorder treatment.

• Hospital stays.

• Family preparation

• Breast – feeding.

• Patient transport services

• Services of rehabilitative and habilitative nature

• Preventive and wellness services and management of chronic conditions

• Lab support

• Prenatal, postpartum, and infant care

• Prescribed pharmaceuticals

 

The Affordable Care Act also mandates that insurance companies include preventive care at no additional cost for customers. These services may include screenings, examinations, immunizations, and patient counselling.

​

Meeting Coverage Requirements Under the Affordable Care Act

Unlike many other available insurance plans, obtaining benefits through the health insurance marketplace is quite straightforward. To be eligible, you must reside in the United States, be a U.S. citizen or lawfully present, and not be in prison. However, if you already have Medicare coverage, you will not be eligible to purchase dental or health policies through the marketplace. To qualify for subsidies under the Affordable Care Act, even though it is not a requirement, your income cannot exceed 400 percent of the federal poverty threshold.