Health Insurance
Individual Health Insurance
The Affordable Care Act (ACA) is a major federal law passed in 2010 designed to expand access to quality, affordable health insurance across the U.S. and improve consumer protections in the health insurance market.
Key ACA Features for Individuals
Broad Access to Insurance
The ACA created regulated Health Insurance Marketplaces where individuals and families without employer coverage can shop for plan options.
Financial Assistance
Households with certain income levels can qualify for premium tax credits and other subsidies to reduce monthly premium costs when they enroll through an ACA Marketplace.
Consumer Protections
Insurance companies cannot deny coverage or charge more because of pre-existing conditions. Essential benefits like hospitalization, prescription drugs, maternity care, and mental health services must be covered by all Marketplace plans.
Essential Health Benefits
All Marketplace plans must include coverage for key services such as
- Emergency care
- Preventive services
- Prescription drugs
- Mental health care
- Maternity and newborn care
Enrollment Periods
Annual Open Enrollment typically runs from November 1 to January 15 each year.
Outside this period, you must qualify for a Special Enrollment Period (SEP) due to life changes such as marriage, job loss, or loss of other coverage.
In Maine, ACA Marketplace health plans are accessed through CoverME.gov, the state’s official health insurance Marketplace where individuals and families can compare, shop for, and enroll in health and dental insurance coverage that meets federal ACA requirements. It’s the only place in Maine where consumers can access ACA financial subsidies to lower coverage costs.
As a licensed agent, I can play a valuable role in helping clients navigate plan choices and enroll correctly, at no cost to you the consumer. I am appointed with all the insurance plans on the Marketplace - Anthem, Community Health Options, Harvard Pilgrim Health Care.