Marketplace Plans

ACA / Obamacare Plans

The Affordable Care Act provides quality health coverage with financial assistance based on your income. We help you find and enroll in the right plan — for free.

What is the Affordable Care Act?

The Affordable Care Act (ACA), also known as Obamacare, created a health insurance marketplace where individuals and families can shop for coverage. Many people qualify for subsidies that significantly lower their monthly premiums.

ACA plans cover essential health benefits including doctor visits, hospital stays, prescription drugs, preventive care, maternity care, and mental health services. No one can be denied coverage for pre-existing conditions.

In El Paso, many families qualify for substantial premium assistance. Some even qualify for $0 or near-$0 monthly premiums. We'll check your eligibility and find the best plan for your situation.

Subsidies Available

Lower premiums based on household income

Essential Benefits

10 categories of mandatory coverage

Open Enrollment

Nov 1 – Jan 15 annually

Family Coverage

Plans for individuals & families

Pre-Existing OK

Can't be denied for health history

Preventive Care

Free screenings & wellness visits

Plan Levels

Understanding ACA Plan Tiers

ACA plans come in four metal tiers. Each tier differs in how costs are split between you and the plan.

Bronze

Plan pays 60%

Monthly PremiumLowest
Out-of-PocketHighest

Good for healthy people who want low premiums and a safety net for worst-case scenarios.

Silver

Plan pays 70%

Monthly PremiumModerate
Out-of-PocketModerate

Best value for many — especially if you qualify for cost-sharing reductions (CSR) on Silver plans.

Gold

Plan pays 80%

Monthly PremiumHigher
Out-of-PocketLower

Great if you use a lot of medical services and want lower costs at the doctor's office.

Platinum

Plan pays 90%

Monthly PremiumHighest
Out-of-PocketLowest

Best for people with high healthcare needs. The plan pays the most, you pay the least per visit.

Eligibility

Who Qualifies for ACA Plans?

Most people under 65 who need health insurance can enroll in an ACA marketplace plan. Many qualify for financial assistance that makes coverage much more affordable.

  • U.S. citizens and legal residents
  • Individuals not currently eligible for Medicare
  • People without affordable employer-sponsored insurance
  • Households earning up to 400% of the federal poverty level may qualify for premium subsidies
  • Special enrollment available for qualifying life events (marriage, birth, job loss, relocation)
  • No denial for pre-existing conditions — guaranteed coverage

Essential Benefits

What's Covered?

All ACA plans must cover these 10 essential health benefit categories:

  • Doctor visits & outpatient care
  • Emergency room services
  • Hospitalization (inpatient care)
  • Maternity & newborn care
  • Mental health & substance abuse services
  • Prescription drugs
  • Physical therapy & rehabilitation
  • Lab tests & diagnostic services
  • Preventive care & wellness screenings
  • Pediatric services (including dental & vision for kids)

Important Dates

Enrollment Periods

Open Enrollment

November 1 – January 15

This is the annual window to enroll in or change your ACA marketplace plan. Plans chosen during this period typically begin on January 1 (or February 1 for later enrollments).

We recommend starting your review early. Contact us in October so we can have your options ready before the window opens.

Special Enrollment

Varies by qualifying event

Qualifying life events — like losing coverage, moving to a new area, getting married, or having a baby — may let you enroll outside the regular window.

You typically have 60 days from the qualifying event to enroll. Not sure if you qualify? Contact us and we'll check for free.

Save Money

Ways to Lower Your Costs

Many people pay less than they expect for ACA coverage. Here's how we help you maximize savings.

Premium Tax Credits

Income-based subsidies that lower your monthly premium. Many El Paso families qualify for $0 or near-$0 premiums.

Cost-Sharing Reductions

Available on Silver plans for lower-income households. Reduces your deductibles, copays, and out-of-pocket maximums.

Medicaid / CHIP

If your income is below certain levels, you or your children may qualify for Medicaid or CHIP — year-round, not just during Open Enrollment.

Choose the Right Tier

We help you pick the plan tier that balances your monthly premium with your expected medical costs.

Use In-Network Providers

Staying within your plan's network keeps your costs low. We verify that your preferred doctors and facilities are covered.

Preventive Care is Free

All ACA plans cover preventive services like annual checkups, vaccinations, and screenings at no additional cost to you.

See If You Qualify for Savings

We'll check your eligibility, compare plans, and help you enroll — all at no cost to you.