The Affordable Care Act (ACA), also commonly referred to as Obamacare, was first implemented in 2010. It was developed with the intention of providing affordable health insurance, while also protecting consumers from insurance companies who would increase patient costs or limit care.

An ACA plan may not be the right option for some, but it could be the right option for you. Let’s go over the different types of plans and the coverage they provide.

Types of ACA Plans

The four main types of ACA plans include:

Health Maintenance Organization (HMO) Plans

With an HMO plan, plan members will receive their healthcare services through a specific network of providers. Plan members are also required to choose a primary care doctor and will need referrals to see specialists. You will most likely have no coverage if you receive care outside of your plan’s provider network.

Preferred Provider Organization (PPO) Plans

PPO plans will allow their plan members to go to any in-network healthcare provider without needing a referral from a primary care doctor. Plan members will also receive some coverage if they go to an out-of-network provider.

Exclusive Provider Organization (EPO) Plans

With an EPO plan, plan members must only use the doctors, specialists, and hospitals that are within the scope of the plan’s network. Plan members cannot go outside of the network and be covered.

Point-of-Service (POS) Plans

POS plans have qualities of both HMO and PPO plans. POS plans will have their plan members choose a primary care doctor and receive referrals to visit with in-network specialists. However, POS plans will also grant plan members the flexibility to receive services outside of the plan’s network.

What do ACA Plans Cover?

All ACA Plans are required to provide coverage for ten essential benefits:

1. Emergency services
2. Hospitalization
3. Lab services
4. Maternity & newborn care
5. Mental health, behavioral health, & substance abuse disorder services
6. Outpatient services
7. Pediatric services
8. Prescriptions
9. Preventive and wellness services
10. Rehabilitative and habilitative services