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ACA individual & family plan basics

Wondering what ACA plans cover, or which plan is right for you? Here's a simple guide to help you with the next steps.

On the Marketplace or off: What’s right for you?

On-marketplace plan 

You can choose to buy this type of plan using the help of a broker, through companies with direct enrollment sites (like us), or on the Health Insurance Marketplace®. (aka “exchange”). This is where individuals and families can compare and shop for health plans. It is run by either the federal or state government depending on where you live. 

Great choice if: 

You qualify for premium discounts or extra savings on your out-of-pocket costs based on your household income.  

Off-marketplace plan

You can buy this type of plan directly through a broker or health insurance company (like us) outside of the official Marketplace (aka “off exchange”). These plans don’t offer premium discounts or extra savings. But you may find additional plan choices.  

Great choice if: 

You make too much money to qualify for financial help. (Tip: Many people think they won’t qualify, but actually do!) 

A guide to plan levels and costs

Every ACA plan is assigned a metal tier: Platinum, Gold, Silver or Bronze. Metal tiers have nothing to do with the quality of care you receive. They determine how you and your plan split costs.

Platinum* 

Premium: Highest  

Out-of-pocket costs: Lowest 

Deductibles: Lowest  

Gold 

Premium: Higher 

Out-of-pocket costs: Lower  

Deductibles: Lower  

Silver 

Premium: Moderate  

Out-of-pocket costs: Moderate 

Deductible: Lower than Bronze plans  

Bronze 

Premium: Lowest

Out-of-pocket costs: Highest

Deductible: Highest 

Coverage for all your health care needs

Every ACA plan covers 10 essential benefits

  • Prescription drugs  
  • Pregnancy, maternity and newborn care 
  • Pediatric services, including oral and vision care  
  • Mental health and substance use disorder services 
  • Preventive and wellness services, and chronic disease management  
  • Laboratory services   
  • Emergency services 
  • Hospitalization 
  • Ambulatory services  
  • Rehabilitative and habilitative services and devices 

 

Big life change or one coming up?

Great news — we’ve got plans for you through our relationship with Aetna CVS Health

That means you can sign up for ACA individual coverage through Aetna CVS Health. Visit their website to check out plan features, shop 2022 plans and see if you qualify for financial help.

Remember to stop back on November 1 during Open Enrollment to choose your 2023 plan.

Find a plan on AetnaCVSHealth.com

Great news — we’ve got plans for you

Visit our simple shopping site to get coverage for 2022 and see if you qualify for financial help.

Remember to stop back on November 1 during Open Enrollment to choose your 2023 plan.

Find a plan

We’re not in your area … yet

We’ve got plans to bring our ACA individual and family plans to more areas. For now, we want to make sure you’re covered.

Had a big life change? You can still get coverage for 2022. Visit the Health Insurance Marketplace® to shop for plans and see if you qualify for financial help.

Remember to visit the Marketplace on November 1 during Open Enrollment to choose your 2023 plan.

Find a plan on HealthCare.gov

Great news — we’ve got plans for you through our relationship with Innovation Health®

That means you can sign up for ACA individual coverage through Innovation Health®. Visit their website to check out plan features, shop 2022 plans and see if you qualify for financial help.

Remember to stop back on November 1 during Open Enrollment to choose your 2023 plan.

Find a plan on InnovationHealth.com

Sign up for updates

We’ll alert you to new information, plan availability, financial help options and more.  

Sign up now

 

Transforming health care, together

Banner|Aetna aims to offer access to more efficient and effective member care at a more affordable cost. We join the right medical professionals with the right technology, so members benefit from quality, personalized health care designed to help them reach their health ambitions.

Contact us

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Health benefits and health insurance plans are offered, underwritten, and/or administered by Banner Health and Aetna Health Insurance Company and/or Banner Health and Aetna Health Plan Inc. (Banner|Aetna). Banner|Aetna is an affiliate of Banner Health and of Aetna Life Insurance Company and its affiliates (Aetna). Each insurer has sole financial responsibility for its own products. Aetna and Banner Health provide certain management services to Banner|Aetna. Aetna, CVS Pharmacy® and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health® family of companies.

98point6® is a registered trademark of 98point6 Inc. Access to 98point6® is not included in all plans. 98point6 is available to members age 1-17 when an adult parent or guardian is also enrolled in the plan.

This material is for information only. An application must be completed to obtain coverage. Rates and benefits vary by location. Providers are independent contractors and are not agents of Banner|Aetna. Provider participation may change without notice.

Health insurance plans contain exclusions and limitations.