Affordable Care Act (ACA) Plans

Who it's for

• Individuals and families without affordable job-based coverage
• Self-employed people and small business owners
• Early retirees under age 65
• Anyone who wants to see whether they qualify for lower premiums

How it works

The Affordable Care Act set standards for individual health plans: they must cover the 10 essential health benefits, they can't deny coverage or charge more for pre-existing conditions, and they have a yearly limit on in-network out-of-pocket costs.

The Health Insurance Marketplace is where you compare those plans and apply for help paying for them. You fill out one application for your household, the Marketplace estimates any premium tax credit and cost-sharing reduction you qualify for, and then you choose a plan. Most of the states Hollen serves use HealthCare.gov; Georgia uses its own marketplace, Georgia Access.

If you take your premium tax credit in advance, it's sent directly to the carrier each month and reconciled when you file your federal taxes.

What it covers

Every ACA-compliant plan covers the 10 essential health benefits:

• Outpatient care (doctor visits)
• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health and substance use services
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care

What affects the cost

Prices aren't one-size-fits-all. These factors usually make the biggest difference:

• Your age (ACA rules limit how much more older adults can be charged)
• Where you live, down to your county and ZIP code
• Tobacco use, which can raise premiums in many states
• Who is on the plan (just you, you and a spouse, or a whole family)
• The metal level and network type you choose
• Household income, which determines any premium tax credit or cost-sharing reduction

ACA-compliant plans can't charge you more because of your health history or a pre-existing condition. Look at the total yearly picture, not just the monthly premium: the deductible, copays, and out-of-pocket maximum matter just as much when you actually use care. Cost-sharing reductions are only available on Silver plans, which is why a Silver plan can be a better value than it first appears for some households.

When you can enroll

For 2027 coverage, Open Enrollment runs November 1, 2026 through January 15, 2027. Choose a plan by December 15, 2026 for coverage that starts January 1; plans chosen December 16 through January 15 generally start February 1. Outside Open Enrollment, you generally need a Special Enrollment Period, usually 60 days after a qualifying life event. People who qualify for Medicaid or CHIP can apply any time of year.

Key things to know

Premium tax credits can lower your monthly premium

Depending on household income and size, you may qualify for a tax credit that reduces your premium. You can apply it in advance each month or claim it when you file taxes. Eligibility rules can change from year to year.

Cost-sharing reductions

If your income falls within certain limits, Silver plans may come with extra savings that lower deductibles, copays, and out-of-pocket maximums.

Metal levels

Bronze, Silver, Gold, and Platinum plans split costs differently between you and the plan. Catastrophic plans are available to people under 30 and some others who qualify.

Open Enrollment happens once a year

Open Enrollment generally begins November 1. The end date can vary by year and by state, so contact Hollen to confirm current deadlines.

Special Enrollment Periods

Outside Open Enrollment, you generally need a qualifying life event, such as losing coverage, moving, marriage, or having a baby, to enroll or change plans.

Report changes during the year

If your income or household changes, update your application. This keeps your savings accurate and helps you avoid surprises at tax time.

Common mistakes to avoid

• Skipping a Silver plan comparison when you may qualify for cost-sharing reductions
• Not reporting income or household changes during the year
• Assuming the plan you had last year is still the best fit after auto-renewal
• Choosing a Bronze plan without being ready for its deductible
• Missing the December 15 deadline for January 1 coverage

How Hollen helps

Hollen is a licensed broker who can help you apply, estimate savings, and compare Marketplace plans from multiple carriers. She'll check your doctors and prescriptions, explain metal levels in plain English, and help you stay on track with renewals and income updates.

Frequently asked questions

Related coverage

Individual / Private Health Insurance · Family Health Insurance Plans · Self-Employed Health Insurance Plans · Student Health Insurance · Relocation Health Insurance

Hollen is licensed in 14 states. See coverage details for South Carolina, North Carolina, Georgia, Texas, Florida, or all licensed states.

This page is general educational information, not a guarantee of coverage, eligibility, or cost. Benefits, availability, and rules vary by plan, carrier, and state. Contact Hollen for details on specific plans.