A Quick Checklist Before Choosing a Health Insurance Plan
- Make sure the health insurance plan covers everything you might need.
- When shopping for health insurance, beware of overly aggressive marketing tactics being used to sell plans or of anyone who won’t let you see the details of what’s covered BEFORE you buy.
- If you are thinking of purchasing short-term health insurance or an Association Health Plan, it is important to pay very close attention to the benefits that are covered. These plans may NOT meet the minimum
Essential Health Benefit (EHB) requirements under the Affordable Care Act (ACA). Selecting the wrong plan can result in higher medical bills.
- Remember that all ACA Health Insurance Marketplace plans accessed through
getcoveredillinois.gov and purchased on Healthcare.gov meet the requirements of the Affordable Care Act (ACA).
- Look at the chart below to see how ACA Marketplace plans can provide you with quality, affordable health insurance coverage.
Consumer Protection/benefit to plan purchase and duration-inclusion mapping
Consumer Protections and Benefits
| Marketplace Plans Purchased on Healthcare.gov | ACA Compliant Plans purchased outside Healthcare.gov | Short Term Limited Duration Plans |
|---|
Is there mandatory coverage of Essential Health Benefits (EHBs)?
| YES | YES | NO |
Must accept everyone who applies and cover pre-existing conditions?
| YES | YES | NO |
Are tax credits and cost sharing reductions available to reduce my out of pocket costs?
| YES | NO | NO |
Are there lifetime coverage limits?
| NO | NO | YES |
Are there limits on consumer's out of pocket costs?
| YES | YES | NO |
Must cover preventive care free of charge?
| YES | YES | NO |
Must cover mental health and substance use disorder treatment?
| YES | YES | NO |
Must cover prescription drugs?
| YES | YES | NO |
Can plans be purchased at any time during the year?
| NO | NO | YES |
Have Questions?
Get Covered Illinois (GCI), a division of the Illinois Department of Insurance, is the official resource for Illinoisans to find quality, affordable health insurance on the ACA Health Insurance Marketplace and get accurate information on exactly what ACA Marketplace plans cover. Free assistance is also available from Certified Application Counselors. Visit GCI: to
Find Local Help and type in you zip code to find an assister in your area.