Qualified Plans

Qualified ACA plans are categorized into four Metallic levels:

  • Bronze
  • Silver
  • Gold
  • Platinum

Each plan covers the same set of Essential Health Benefits as required by the Affordable Care Act (ACA).

Essential Health Benefits

Qualified health plans include 10 Essential Health Benefits

  • Hospitalization - A stay in the hospital including inpatient surgery and recovery
  • Emergency Services - Visits to the ER including ambulance service or treatment at an urgent care facility
  • Ambulatory Services - Doctor visits when you are sick or injured and outpatient clinic visits
  • Prescription Drugs - Medicine your physician prescribes
  • Laboratory Services - X ray, MRI, blood testing and more
  • Maternty and Newborn Care - Prenatal care including complications and delivery
  • Pediatric Services - Includes oral and vision care, dental check ups, routine eye exams, eyeglasses, immunizations and more
  • Preventive and Wellness Services - Annual screenings including treatment for long-term illnesses
  • Mental and Behavioral Health and Substance Disorder Services
  • Rehabilitative and Habilitative Services and Devices - Physical therapy, speech therapy, artificial limbs and other medical equipment