FAQs about Affordable Care Act and more

FAQ

Need more info?
Review some FAQ's below like: 

  • Levels of Coverage for Affordable Care Act Plans
  • List of Essential Health Benefits
  • Open Enrollment Dates
  • Special Enrollment Exceptions

FOR OTHER QUESTIONS, CALL:

866.454.4458

Levels of Coverage for Affordable Care Act Plans


Bronze Level Plan is 60% AV (Actuarial Value)

bronze level

The health insurance plan pays approximately 60% of the average cost of all Essential Health Benefits for an average person.

Silver Plan Level is 70% AV (Actuarial Value)

silver level

The health insurance plan pays approximately 70% of the average cost of all Essential Health Benefits or an average person.

Gold Level Plan is 80% AV (Actuarial Value)

gold level

The health insurance plan pays approximately 80% of the average cost of all Essential Health Benefits for an average person.

Platinum Level Plan is 90% AV (Actuarial Value)

platinum level

The health insurance plan pays approximately 90% of the average cost of all Essential Health Benefits for an average person.

*This is a brief description of the levels of coverage and is for illustration purposes only.  For more details, contact AXS Health at 866.454.4458 or visit Healthcare.gov.  
 Also available based on qualification, is a catestrophic plan. Learn more at Healthcare.gov.

Essential Health Benefits


Essential Health Benefits (EHB) must include items and services within the following 10 categories.

Essential Health Benefit - Ambulatory Patient Services, such as doctor visits

AMBULATORY PATIENT
 SERVICES, SUCH AS
 DOCTOR VISITS 
 

Essential Health Benefit - Hospitalization

HOSPITALIZATION



    

Essential Health Benefit - Mental Health & Substance Use Disorder Services, including Behavioral Health Treatment

MENTAL HEALTH &
 SUBSTANCE USE DISORDER SERVICES, INCLUDING
 BEHAVORIAL HEALTH
 TREATMENT

Essential Health Benefit - Rehabilitative & Habilitative Services and Devices

REHABILITATIVE &
HABILITATIVE SERVICES
 & DEVICES

  

Essential Health Benefit - Laboratory Services

LABORATORY SERVICES



    

Essential Health Benefit - Emergency Services

EMERGENCY SERVICES

Essential Health Benefit - Maternity & Newborn Care

MATERNITY &
NEWBORN CARE 

Essential Health Benefit - Prescription Drugs

PRESCRIPTION DRUGS 

Essential Health Benefit - Preventive & Wellness Services & Chronic Disease Management

PREVENTIVE & 
WELLNESS SERVICES &
CHRONIC DISEASE
MANAGEMENT   

Essential Health Benefit - Pediatric Services (Pediatric Oral Care may be included or offered as part of a stand-alone dental plan)

PEDIATRIC SERVICES
(PEDIATRIC ORAL CARE
MAY BE INCLUDED OR
OFFERED AS PART OF
A STAND-ALONE
DENTAL PLAN)     

open enrollment dates


Open Enrollment Begins

2017 Open Enrollment Begins on November 1, 2016

November 1, 2016

Open Enrollment Ends

2017 Open Enrollment Ends on January 31, 2017

January 31, 2017

Note: December 15, 2016 is the last day to enroll for a January 1, 2017 effective date.

Special Enrollment Exceptions


Special Enrollment Period (SEP) is a time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you've had certain life events, including:

Special Enrollment Exceptions - Loss of Health Coverage

LOSS OF HEALTH COVERAGE 

Special Enrollment Exceptions - Moving

MOVING

Special Enrollment Exceptions - Getting Married

GETTING MARRIED

Special Enrollment Exceptions - Having a Baby

HAVING A BABY

Special Enrollment Exceptions - Adopting a Child

ADOPTING A CHILD

If you qualify for an SEP, you usually have up to 60 days following the event to enroll in a plan. If you miss that window, you have to wait until the next Open Enrollment Period to apply.  For more information and specifics and to see if you qualify for a Special Enrollment Period, click on the link below.

MORE ABOUT SPECIAL ENROLLMENT PERIODS

Note: This is a brief description of Special Enrollment Periods and Exceptions.  To learn full definitions and qualifications, go to healthcare.gov or use the link above.