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Key Resources & FAQ

FAQ

We want to simplify your life. In the following you see answers to some questions that might arise.

What is The Affordable Care Act?

The Affordable Care Act (ACA), often called "Obamacare", is a law passed in the U.S. in 2010. Its main goal is to make health insurance more affordable, accessible, and of better quality for Americans.

Who qualifies for coverage under ACA?

Most Americans can get coverage under the ACA. It's designed especially for those without insurance and those who buy their own. Some low-income individuals might qualify for extra savings or benefits, depending on their earnings and the state they live in.

How do I enroll for health coverage?

You can enroll during the "Open Enrollment" period by visiting the official Health Insurance Marketplace website. Outside of that period, you'd need a special life event, like getting married or having a baby, to enroll.

Can I enroll my family members?

Yes, you can! When you apply through the Marketplace, you can include your spouse and any dependents you'd like to add to your policy.

What's the difference between a premium and deductible?

A premium is the amount you pay, often monthly, to have health insurance. Think of it like a subscription fee. A deductible, on the other hand, is the amount you pay for health services before your insurance starts to chip in. For example, if your deductible is $500, you pay the first $500 of your medical bills before your insurance covers the rest.

Who is Lyve Health?

Lyve Health is a national Affordable Care Act brokerage, meaning we help you gain quick and easy access to health insurance providers, and even recommend the best plans for you and your household. We take the guesswork out of healthcare so you can rest easy!

ACA Definitions & Glossary

ACA (Affordable Care Act)

 Often referred to as "Obamacare", this is a U.S. healthcare reform law passed in 2010 aimed at increasing the quality, affordability, and attainability of health insurance.

Coinsurance

The percentage of costs of a covered healthcare service an individual pays after having paid their deductible.

Copayment (or Copay)

A fixed amount paid by an individual at the time of receiving a medical service, with the remaining balance covered by their health insurance.

Deductible

The amount an individual must pay for healthcare services before their insurance begins to pay.

Essential Health Benefits A set of 10 health care service categories that must be covered by certain plans, including outpatient care, emergency services, hospitalization, and maternity care.
HMO (Health Maintenance Organization) A type of health insurance plan where members need to get a referral from their primary care doctor in order to see a specialist.
Medicaid A joint federal and state program that provides health coverage to individuals with low income, including some adults, children, pregnant women, elderly adults, and individuals with disabilities.
Medicare A federal program that provides health coverage for seniors aged 65+ and some younger individuals with disabilities.
Network A group of doctors, hospitals, and other healthcare providers that have agreed to provide medical services at negotiated prices with an insurance company.
Out-of-Pocket Maximum/Limit The most an individual has to pay for covered services in a policy period (typically a year). After reaching this amount, the health insurance will pay 100% of the costs of covered benefits.
Premium

 The amount paid, often monthly, for health insurance coverage.

Pre-existing Condition

A health condition that existed before an individual's health insurance policy began.

PPO (Preferred Provider Organization) A type of health insurance plan where members can use any doctor or specialist they want without a referral.
Subsidy Financial aid provided by the government to help individuals pay for their health insurance, usually determined based on income.