Plan Types | ObamacareUSA.org

Every Type of Plan in One Place

ObamacareUSA.org connects you to virtually every health plan available in District of Columbia. While you shop around it is important to learn about the types of plans if you do not already know the differences. The Affordable Care Act has established two main categories of health plans:

1) Marketplace Plans, also known as “Obamacare Plans” and

2) Short Term Plans, also known as “Private Insurance.”

Obamacare Plans, or the first category, are those plans established by the federal and/or state government. You can enroll in Obamacare Plans during the Open Enrollment Period. If you missed Open Enrollment, you can still sign up for these plans after the deadline has passed, but only if you have a Qualifying Life Event.

Obamacare Plans are broken down into four coverage types. These levels of coverage are known as the “Metal Tiers” and are as follows:

1) Bronze; 2) Silver; 3) Gold; and 4) Platinum. Bronze has the cheapest monthly/yearly premium cost, but you pay more out-of-pocket when you see the doctor. Platinum, by contrast, has higher premiums, but you pay a lot less out-of-pocket. Remember that the premium costs for any one of these tiers can be greatly lowered if you qualify for a subsidy.

Separate from the four metal tiers is a fifth level of coverage known as the “Catastrophic Plan.” It is the most inexpensive plan, but it is designed to mainly cover you in the event of an emergency or a severe illness. Learn more about Obamacare Plans and the five coverage types here

Short Term Plans, or the second category, are best for those who missed Open Enrollment and do not have a Qualifying Life Event. Short Term plans are meant to be a temporary option and to fill in a gap of coverage until Open Enrollment comes around again or until you have a Qualifying Life Event, like a new job.

Short Term Plans are sometimes referred to as “Private Insurance” because they are very similar to how health insurance used to be before the government stepped-in and launched the Affordable Care Act. Unlike Obamacare Plans, you may be denied for preexisting conditions. The good news is that monthly rates tend to be low and if you are denied coverage by one insurer, there are others that do not have as strict eligibility requirements. Use ObamacareUSA.org to shop around and learn more about Short Term Plans here

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Important Information: Disclaimer:

ObamacareUSA.org is operated by Quotelab, LLC, which is an independent broker and is not a federal or state Marketplace website. This website is owned and operated by QuoteLab, LLC, a licensed insurance agency, NPN #19911386. Invitations for application for health insurance on QuoteLab, LLC, only where licensed and appointed. License numbers are available upon request and are provided where required by law. QuoteLab's license information can be found at https://www.quotelab.com/licenses.html.

Federal Contracting Statement: The Medicare plans represented are PDP, HMO, D-SNP, PPO or PFFS plans with a Medicare contract. Enrollment in plans depends on contract renewal. No Obligation to enroll.

TPMO Disclaimer: We do not offer every plan available in your area. Currently we represent [73] organizations which offer [5110] products in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Please note that these numbers provided are not specific to your area but rather represent the number of organizations and the number of products available on a national basis. We will connect you with licensed insurance agents who can provide information about the number of organizations they represent and the number of products they offer in your service area.

Submitting this form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage plan, Medicare Prescription Drug plan, Medicare Supplement Plan, or any other Medicare plan. QuoteLab, LLC is independent of the Medicare program and is neither associated with nor endorsed by The Centers for Medicare & Medicaid Services (CMS) or any other governmental agency.

The plans represented on ObamacareUSA.org are Medicare Advantage HMO, PPO and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal. If you are paying Medicare Part B premium, you must continue to pay it to maintain coverage.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Every year, Medicare evaluates plans based on a 5-star rating system.

Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

Based on median Medicare Advantage benefit amounts for dental available across multiple plans and metro areas. Not all benefits available in specific plans or regions.

This information is not a complete description of benefits. Contact the plan for more information.

Limitations, copayments, and restrictions may apply.

[Benefits, premiums and/or copayments/coinsurance] may change on January 1 of each year.

Enrollment in a plan may be limited to certain times of the year unless you qualify for a special [election/enrollment] period or you are in your Medicare Initial Election Period.

Advertised Pricing:

There are several factors that impact your monthly premium; including your age, geographical location, annual income, dependents, and the type of plan you choose. Monthly premiums do not include out-of-pocket costs.

ObamacareUSA.org is operated by QuoteLab, LLC, which is an independent broker and is not a federal or state insurance Marketplace or other website. It does not provide access to any federal or state marketplace or exchange. This website is owned and operated by QuoteLab, LLC, a licensed insurance agency, NPN #19911386. Invitations for application for health insurance are made through QuoteLab, LLC, only where licensed and appointed. License numbers are available upon request and are provided where required by law. QuoteLab's license information can be found at https://www.quotelab.com/licenses.html.

This website does not provide information about specific health plans, or enable visitors to obtain insurance quotes, on this website. However, if you provide your information and consent, we will transfer your information to insurance carriers and brokers that may contact you to offer Affordable Care Act (ACA) plans, short-term plans, medical indemnity plans and/or healthcare sharing ministry plans, and we will receive compensation for such transfer. The advertisements appearing on this website are placed by clients from which QuoteLab, LLC receives compensation, and such compensation may impact whether such advertisements appear on this website and the order in which they appear.

ObamacareUSA.org is required to comply with all applicable federal law, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website does not provide a complete listing of, or display all data on all Qualified Health Plans being offered in your state or service area through the Marketplace website or the federal Medicare program. To see all available data on Qualified Health Plan options in your state, visit your state Marketplace website, go to the Health Insurance Marketplace website at https://www.healthcare.gov.

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Note that even with a $0 premium Medicare Advantage plan, you'll still pay a monthly premium for Part B, and a Part D premium if your Medicare Advantage plan does not include prescription drug coverage (MA-PD).

Allowance Disclaimer: Allowance amounts cannot be combined with other benefit allowances. Limitations and restrictions may apply.

** Members may receive a monthly or quarterly allowance in the form of a benefits prepaid card to pay for a wide range of approved groceries and utilities. Unused amounts will expire at the end of the month or quarter.

* The benefits mentioned are Special Supplemental Benefits for the Chronically Ill (SSBCI). You may qualify for SSBCI if you have a high risk for hospitalization and require intensive care coordination to manage chronic conditions such as Chronic Kidney Diseases, Chronic Lung Disorders, Cardiovascular Disorders, Chronic Heart Failure, or Diabetes. For a full list of chronic conditions or to learn more about other eligibility requirements needed to qualify for SSBCI benefits, please refer to Chapter 4 in the plan’s Evidence of Coverage.

Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.

¹Transportation services are issued as one-way trips and provided on an annual basis. Benefits vary by plan.