Whether you call it Obamacare, the marketplace, or ACA coverage, it's the same thing: real major-medical insurance that can't turn you down for your health history — and the only kind that comes with income-based premium help. Here's what every plan must cover, what 2026 actually costs, when you can enroll, and the free tools to run your own numbers.
Federal law requires every marketplace plan — bronze through platinum, every carrier, every state — to cover ten essential health benefits: outpatient care, emergency services, hospitalization, pregnancy and newborn care, mental health and substance-use treatment, prescription drugs, rehabilitative services, lab work, preventive care, and pediatric care. Preventive services like annual checkups, screenings, and immunizations are covered at no cost to you, even before you meet the deductible.
What varies between plans isn't whether these categories are covered — it's how much you pay when you use them (deductibles, copays, coinsurance) and which doctors and hospitals are in network. That's why two plans with the same premium can behave completely differently when you actually get sick. The metal-tier comparison tool shows how the math shifts across bronze, silver, and gold for your situation.
Sticker prices rose sharply for 2026 and the temporarily enhanced subsidies from 2021–2025 expired on December 31, 2025 — which is why many renewals came as a shock. But the original ACA premium tax credits are still in place: if your household earns between 100% and 400% of the federal poverty level, the law caps what you pay for the benchmark silver plan at a percentage of your income, and the government pays the rest directly to the carrier.
Two things most people miss:
1. Cost-sharing reductions. Under 250% of the poverty level, a silver plan quietly upgrades — lower deductibles and out-of-pocket maximums at no extra premium. For many households this makes silver dramatically better than its sticker suggests, but only on silver plans.
2. The employer-affordability test. If job-based coverage would cost more than 9.96% of your household income for employee-only coverage, you may qualify for subsidies instead — and your family's eligibility is tested separately. The employer coverage checker runs the IRS test in a minute.
Your actual price depends on your ZIP code, age, household, and income — statewide averages can't tell you your rate. Start with the subsidy calculator, then check your state's 2026 cost guide for carrier-by-carrier detail.
Tell me your ZIP code, ages, and income — I'll compare every plan filed in your county, subsidies included, and show you what you'd actually pay. Free, about 10 minutes.
No cost. No obligation to enroll. Licensed in 23 states.
The annual window to buy 2027 coverage in most states — and recent federal rule changes made it a month shorter than people are used to. Don't plan on a January deadline that no longer exists.
Losing other coverage, moving, getting married, having a baby, and certain income changes each open a 60-day window to enroll mid-year. The special enrollment checker tells you in 60 seconds whether a window is open for you right now.
If your income qualifies, Medicaid and CHIP have no enrollment window at all. The Medicaid eligibility checker shows where you stand in your state.
COBRA quotes you 102% of the full premium with zero subsidy, while the same event opens a subsidized marketplace window. Run the COBRA vs. marketplace comparison before either 60-day clock runs out.
Every tool below is built and maintained by a licensed agent, runs in your browser, and asks for nothing but numbers. Use them first; call only if you want a second set of eyes.
Estimate, check, and compare before you ever talk to anyone:
Plain-English explainers when you want the full picture:
Yes — "Obamacare," "ACA plans," and "marketplace insurance" all describe the same coverage: individual and family plans sold under the Affordable Care Act. Same plans, same prices, whether you enroll on HealthCare.gov, a state marketplace, or through a licensed agent.
No. ACA plans cannot deny you, charge you more, or exclude treatment based on your health history. Pricing considers only age, location, household size, income, and tobacco use. This is the single biggest difference between ACA plans and short-term or non-ACA alternatives, which can and do underwrite.
Yes. What expired on December 31, 2025 was the temporary enhancement. The permanent premium tax credits — for households between 100% and 400% of the federal poverty level — are still the law. If your renewal jumped, re-run your numbers with the subsidy calculator before assuming you don't qualify.
A qualifying life event in the last 60 days — losing coverage, moving, marriage, a new baby, certain income changes — may open a Special Enrollment Period right now. Check in 60 seconds. Medicaid and CHIP enroll year-round if you qualify.
Price-wise there's no difference — premiums are fixed by law and carriers pay the commission either way. The value is in the details that don't show on the shopping screen: which networks include your doctors, how your drugs land on each formulary, silver-tier upgrades you might not know you qualify for, and someone to call when a claim goes sideways. Prefer DIY? Quote online yourself with the same licensed tools.
Important: This page is educational and reflects federal rules for the 2026 plan year. Submitting information or speaking with a licensed insurance agent does not guarantee enrollment, eligibility, savings, approval, or specific benefits, and there is no obligation to enroll. Plan availability, benefits, premiums, and subsidy eligibility vary by plan, carrier, location, household, and income. Smooth Health Solutions is not connected with or endorsed by the U.S. government, HealthCare.gov, CMS, or any state marketplace.