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Affordable Care Act (ACA)
The ACA marketplace connects you with health plans, financial assistance, and expert support. Choose your path below to get started.
What is ACA?
The Affordable Care Act (ACA), often referred to as “Obamacare,” is a comprehensive healthcare reform law enacted in 2010 aimed at expanding health insurance coverage, reducing healthcare costs, and providing preventive care. The law includes provisions such as the creation of health insurance marketplaces, the expansion of Medicaid, and the establishment of 10 essential health benefits that insurance plans must cover.
Qualifying health insurance coverage, also known as minimum essential coverage, refers to any health insurance plan that meets the standards set by the ACA. Any health insurance plan that does not meet the minimum requirements is not considered a “major medical” plan.
Qualifying health insurance coverage, also known as minimum essential coverage, refers to any health insurance plan that meets the standards set by the ACA. Any health insurance plan that does not meet the minimum requirements is not considered a “major medical” plan.
Covered
Annual routine check ups
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Eyeglasses and contacts
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Hospitalization
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Maternity and newborn care
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Eyeglasses and contacts
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Mental health and substance use disorder services
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Additional item
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Not Covered
Prescription drugs
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Rehabilitative and habilitative services and devices
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Cosmetic treatments
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Laboratory services
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Preventive and wellness services and chronic disease management
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Pediatric services, including oral and vision care
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Do You Need ACA?
As of 2019, the ACA individual mandate is no longer being enforced with a federal tax penalty for adults 26 and older who opt out of coverage without qualifying for an exemption. However, some states have individual mandates and tax penalties for going without qualifying coverage.
Even though you can’t be penalized under federal law for not having major medical coverage, you may still consider these ACA plans if you:
Aren’t already covered on a parent’s or employer’s major medical plan Have a pre-existing condition – major medical plans are guaranteed issue, so you’ll always be able to enroll, and you can’t be charged more because of health conditions you had before the date coverage starts. Qualify for a subsidy – you may be able to get an ACA plan at a more affordable rate than you think. Rely on prescription drugs – major medical health plans are required to offer drug coverage, and the scope of drugs that they cover could be more expansive than with other non-qualifying health plans. Live in a state with an ACA tax penalty
Frequently asked questions
Are you integrated with the Marketplace?
Are you integrated with the Marketplace?
If this is free, how do you make money?
If this is free, how do you make money?
The purpose of a FAQ is to provide answers to common questions and help users find the information they need quickly and easily.
Do you have training?
Do you have training?
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Still have questions? See all FAQs.
Everything you need, in one marketplace
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- Know what you're paying upfront. No surprises or hidden fees.
- From preventative care to urgent service
- Get recommendations tailored to your needs
Call a licensed broker for clear guidance.
Call 888-383-5527Footnotes
Oscar Medical coverage is underwritten by Oscar Insurance Company located in New York, New York. Plans sold in New York are underwritten by Oscar Insurance Corporation located in New York, New York. Plans sold in Florida are underwritten by Oscar Insurance Company of Florida. Plans sold in New Jersey are underwritten by Oscar Garden State Insurance Corporation. Administrative Services for all plans provided by Oscar Management Corporation. Plans sold in Texas use policy and associated COC form numbers OSC-TX-IVL-HMO-EOC-2025-HIX OHIN-134128348; OSC-TX-IVL-HMO-EOC-2025 OHIN-134128297; GUIDED OSC-TX-IVL-HMO-GOLD-GUIDED-CARE-EOC-2025 OHIN-134128360; OSC-TX-IVL-EOC-2025 OHIN-134080911;OSC-TX-IVL-EOC-2025-HIX OHIN-134080906; OSC-TX-S-IVL-EOC-2025-HIX OHIN-134079760; OSC-TX-S-IVL-EOC-2025 OHIN-134079760. Plans sold in Virginia use policy and associated form numbers VA ON OSC-VA-IVL-EOC-2025-HIX OHIN-134065976; VA OFF OSC-VA-IVL-EOC-2025 OHIN-134065976.