Often lower premiums with more cost-sharing when care is used.
Knowledge changes everything
UNDERSTANDING ACA
Understand Marketplace coverage before choosing a plan.
What Marketplace insurance is
ACA Marketplace plans are comprehensive individual health insurance policies sold by private insurance companies. They cover essential health benefits and follow consumer-protection rules.
Who can enroll?
Eligible individuals and families can apply. Access to Medicare, Medicaid or employer coverage can affect eligibility for financial assistance.
When you can enroll
Open Enrollment
Open Enrollment is the annual period for choosing or changing Marketplace coverage. Dates and procedures can vary by coverage year and Marketplace.
Special Enrollment Periods
Life changes such as losing qualifying coverage, moving, marriage, birth or adoption may provide a limited opportunity to enroll outside Open Enrollment.
Premium tax credits
Eligible households may receive advance premium tax credits that reduce monthly premiums. Estimates consider projected annual household income, tax household size and other factors.
Household income and size
An application generally considers the people in the tax household and their expected income for the coverage year.
2026 federal table
Premium Tax Credit
Estimated premium contribution percentages
The percentage below is the estimated share of household income used to calculate the household contribution toward the benchmark Marketplace plan. Within a range, the percentage generally increases as income rises.
| Household income as a percentage of the federal poverty level | Initial percentage | Final percentage |
|---|---|---|
| Less than 133% | 2.10% | 2.10% |
| At least 133% but less than 150% | 3.14% | 4.19% |
| At least 150% but less than 200% | 4.19% | 6.60% |
| At least 200% but less than 250% | 6.60% | 8.44% |
| At least 250% but less than 300% | 8.44% | 9.96% |
| At least 300% but not more than 400% | 9.96% | 9.96% |
Important: This table is for general education, not a premium quote or guarantee of eligibility. Actual assistance depends on household information, the benchmark plan, location and current federal rules.
Source: IRS Revenue Procedure 2025-25.
Bronze through Platinum
05 · Dental coverage
Dental plans deserve a closer look
Dental coverage may be available alongside your medical coverage. Steve can help you compare available dental plan options and review important details before you choose.
- Check whether your dentist participates
- Review covered services and plan limits
- Understand waiting periods and out-of-pocket costs
Know the full cost
- Premium
- The amount paid to keep coverage active.
- Deductible
- What may be paid before the plan begins paying for many services.
- Copay
- A fixed amount for a covered service.
- Coinsurance
- A percentage of a covered service's allowed cost.
- Out-of-pocket maximum
- The most paid for covered in-network care during a plan year, excluding premiums and certain costs.
Prescriptions and provider networks
Drug formularies, provider networks and HMO, EPO or PPO arrangements vary by plan and area. Verify doctors, hospitals and prescriptions before enrolling.
Common ACA questions
Can self-employed people get ACA insurance?
Yes. Eligibility for financial assistance depends on circumstances including projected household income and household size.
Can I enroll outside Open Enrollment?
A qualifying life event may create a Special Enrollment Period.
What if my income changes?
Report changes promptly to the applicable Marketplace because they may affect financial assistance.
Can I choose my doctors?
Plan networks vary. Check participation with both the plan and provider.
What happens when I turn 65?
Medicare and ACA follow different rules, so plan ahead before changing coverage.