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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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: Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

Third Party Material (TPMO) (Medicare.gov): We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

This website may not display all data on Qualified Health Plans being offered in your state through the Marketplace website or the federal Medicare program. This is not a complete listing of plans available in your service area. 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 or consult https://www.medicare.gov.

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.

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.

The advertised price may not be typical. It was generated using the Kaiser Family Foundation's subsidy calculator that was accessed on September 16, 2020. The following parameters were used: 21 year old adult, non-tobacco user, annual income of $24,700 in 2020, no children, and no available coverage through a spouse's employer. The resulting monthly premium was $30 per month (or $360 per year after $2,751 in subsidies) for a Bronze Plan. Even when using the same parameters, the resulting premium and subsidy calculations may be subject to change.