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What is the difference between ACA-compliant health insurance plans and non-compliant plans?

There are several notable differences between plans which are compliant with the Affordable Care Act (ACA) and those which are not. First, ACA-compliant plans will offer coverage for the ACA’s ten essential health benefits, including maternity, preventive services, and mental health care. They will not turn you down, limit coverage, or charge you more because of a pre-existing condition. ACA-compliant plans can be purchased both on and off the exchange, but regardless of where you choose to get one, an ACA-compliant plan can only be purchased during open enrollment or a special enrollment period. Plans purchased through the exchange are also eligible for subsidies.

Plans which are not compliant with the ACA can and will charge more or deny coverage for pre-existing conditions. If a plan’s application asks you questions about your health status or history, it is almost certainly not an ACA-compliant plan. Non-compliant plans do not have to cover all essential health benefits and will typically have annual or lifetime caps on the benefits you can receive. Because of their limited benefits and ability to deny coverage to those in bad health, non-compliant plans typically have lower premiums than compliant ones. Unlike ACA-compliant plans, non-compliant plans can be purchased year-round regardless of whether you have qualified for a special enrollment period. Non-compliant plans cannot be purchased through the exchange and cannot have subsidies applied to them.

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