The health insurance Marketplace (also known as the ACA Marketplace) is where you can purchase a health plan for you and your family. UnitedHealthcare offers a variety of Individual & Family ACA Marketplace plans. If plans are available in your area, you may be able to shop and enroll directly through UnitedHealthcare.
All health plans available on the ACA Marketplace offer quality care that supports your health and wellbeing. Plans are organized into 3 categories — Bronze, Silver and Gold. Also called metal levels, these categories determine your cost of care and amount of coverage. They don’t impact the quality or type of care you’ll get. A wide range of UnitedHealthcare ACA plans are available in these 3 metal levels.
You may want to choose this plan if you rarely see your doctor. Bronze plans help with the cost of worst-case medical scenarios, like serious illness or injury. You’ll have a low monthly premium but pay more when you get care.
If you typically just see your provider for routine preventive care, consider a Silver plan. You’ll pay a slightly higher monthly premium than Bronze plans, but you’ll get more coverage. Silver plans may also qualify for cost-sharing reduction savings.
If you see your doctor often during the year, a Gold plan may be a good choice for you. You’ll pay a higher monthly premium each month but pay less when you get care.
A UnitedHealthcare Individual & Family ACA Marketplace plan could be a good fit if:
You’re new to buying your own health insurance You don’t get or don’t want health insurance through your employer You’re self-employed You’re not eligible for Medicare or Medicaid Your employer offers reimbursement to help cover the cost of a health plan you purchaseDepending on your household income, you may qualify for low or even $0 health plans 2 , which can help make health coverage more affordable than you may expect. Over half of our members paid $0 monthly premium in 2024. 1 Here are a few ways you may be able to save.
ACA Marketplace plans are health care plans that people can buy on their own, rather than through an employer or another government-run program, like Medicare or Medicaid. You might also hear names like Exchange plans and Individual & Family Plans. The ACA Marketplace (also called the Exchange) is where ACA health care plans are sold.
Under the American Rescue Plan Act of 2021 (ARPA) and Inflation Reduction Act of 2022, you may be able to enroll in ACA Marketplace coverage with lower premiums — and you can see if you qualify for financial subsidies. These subsidies could be tax credits or cost-sharing reductions to help pay for your health care costs.
A pre-existing condition is a health issue you had before your health plan starts. Under current law, companies offering ACA Marketplace health plans that meet minimum essential coverage requirements can't refuse to cover you or charge you more because of a pre-existing condition.
A copay (or copayment) is a fixed amount you may pay for a covered health care service, usually at the time you receive the service.
You might remember times when you went in for a doctor visit and maybe paid a $15 or $20 copay before or after your visit (copay amounts vary depending on the provider and service). That’s how copays work. With health plans that have copays (not all do), you’ll know what you have to pay ahead of time, which can help you budget your health care costs. For most plans, your copay does not apply toward your deductible.
Coinsurance is a percentage of the cost of a health care service, and it’s what you pay once you meet your deductible. A common coinsurance amount is 20%, but the cost-sharing percentages could be anything.
If your doctor visit costs $100 and you’ve met your deductible, your coinsurance payment of 20% would be $20 out-of-pocket. Your insurance would then pay the rest of the allowed amount ($80) for covered health care services.
You might have heard terms like out-of-pocket max or limit. They mean the same thing. They each refer to the most you could pay during a 12-month coverage period for your share of the costs of covered services. Typically, deductibles, copays and coinsurance all count toward your out-of-pocket maximum. Things like your monthly premium or anything your plan doesn't cover (like out-of-network services) do not.
If you meet your out-of-pocket maximum, your plan will pay for 100% of your covered health care costs (up to the allowed amount). Let’s say you have an annual out-of-pocket maximum of $6,000. That means once you’ve paid $6,000 out-of-pocket for your covered health care, usually including deductibles, copays and coinsurance, your plan will cover any future (covered, in-network) health care services during your coverage period.
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Get helpful tips and information to help you better understand your options. 3
The benefits described may not be offered on all plans or in all states. Some plans may require copayments, deductibles and/or coinsurance for these benefits. The policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, review the plan coverage documents, or call or write your insurance agent/broker or the company, whichever is applicable. By responding to this offer or communication, you agree that a representative may contact you.
UnitedHealthcare Individual & Family plans medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization Incorporated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Company in AL, IN, KS, LA, MO, NE, NJ, TN, and WY; Optimum Choice, Inc. in MD and VA; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of Mississippi, Inc.; UnitedHealthcare of New Mexico, Inc.; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Ohio, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of South Carolina, Inc.; UnitedHealthcare of Texas, Inc.; UnitedHealthcare of Oregon, Inc. in WA; UnitedHealthcare of Wisconsin, Inc., and UnitedHealthcare Plan of the River Valley in Iowa. Administrative services provided by United HealthCare Services, Inc. or their affiliates.
