About the Affordable Care Act
How the law works
The Affordable Care Act (ACA) was created to make health benefits more affordable and accessible for everyone.
The Centers for Medicare & Medicaid Services (CMS) requires all Qualified Health Plans (QHPs), including Moda Health to post notification on its website explaining the necessity of rate increases.
Rate increase justification for Moda Health’s marketplace plans can be found at ratereview.healthcare.gov.
Keep these rules in mind
- You must have health coverage. If you don’t have a health plan through your employer, Medicare or Medicaid, you’ll need an individual or family policy. You could face a fine if you don’t enroll in health coverage. And going without a plan means you’re responsible to pay for all of your care if you get sick or hurt.
- You can’t be rejected for having a pre-existing condition. If you were sick or had a health problem before applying for health coverage, you won’t be denied based on that reason.
- You won’t pay more for being sick. Your monthly premium is based on your age and region, not your health status.
- Your in-network preventive care is covered in most cases. Preventive care keeps you healthy. Examples are vaccines, regular check-ups with your doctor and screenings.
You are guaranteed a certain level of coverage. Health plans need to meet ACA coverage requirements. Also, there’s no annual or lifetime dollar limit for the benefits that are essential to keeping you healthy.
You can get help paying for your medical plan. If you meet certain income levels, you may qualify for federal financial assistance to help pay for your coverage.
Explore ways to save
Applying for financial assistance
Visit the federal Marketplace, HealthCare.gov, to learn about financial assistance options, like advance premium tax credits (APTC) and cost-sharing reductions. Use the tools there to estimate your eligibility based on income and household size.
Using your financial assistance
If you think you qualify for APTC and want to use it, you can start here by telling us where you live. We will estimate the amount of financial assistance you may qualify for and show you our plans so you can choose one that works for you. Then, you’ll complete your enrollment at HealthCare.gov.
When you enroll, you’ll get to choose how much tax credit to apply to your monthly premium. That lets you reduce the amount you pay each month. If you opt to use less than the total credit you qualify for, you can get the balance refunded with your taxes.
If you qualify for cost-sharing reduction, you’ll see those plans when you enroll at HealthCare.gov. Also known as “extra savings,” cost-sharing reduction plans may offer lower deductible, coinsurance and copay amounts or reduced out-of-pocket maximums.