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Comprehensive coverage for life’s unexpected moments

Your health insurance needs depend on your personal circumstances. It can be obtained through an employer, purchased from the Health Insurance Marketplace created by Affordable Care Act (ACA), or through government programs like Medicare and Medicaid. Choosing the right plan involves considering your health needs, financial situation, and preferred doctors. Evaluating factors like premiums, deductibles, and whether your preferred providers are in-network will help you find the best coverage for you and your family.

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Types of health insurance plans

• Health Maintenance Organization (HMO): Plans that limit coverage to care from a network of doctors and require a primary care physician (PCP) referral to see specialists.

 

• Preferred Provider Organization (PPO): Plans that allow you to see any doctor or specialist without a referral. You pay less if you use providers in the plan's network.

 

• Exclusive Provider Organization (EPO): Plans that cover services only from doctors and hospitals within the plan's network, except in emergencies. Key cost terms to understand

 

• Premium: The regular payment you make to your insurance provider to keep your coverage active.

 

• Deductible: The amount you must pay out-of-pocket for covered medical services before your insurance starts to pay.

 

• Copay: A fixed amount you pay for a covered healthcare service after you've met your deductible.

 

• Coinsurance: The percentage of costs you pay for a covered service after you've met your deductible. For example, if your plan covers 80% of costs, you would be responsible for the remaining 20%.

 

• Out-of-pocket maximum: The most you have to pay for covered services in a plan year. Once you reach this limit, your health plan pays 100% of your covered expenses.

Is ACA insurance right for you?

ACA plans are an excellent option for those who do not have access to affordable health insurance through an employer or a government program like Medicare or Medicaid. Whether you are self-employed, between jobs or want to explore your options, the ACA Marketplace provides a clear path to finding the right plan for your needs.

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Essential health benefits All ACA-compliant plans are required to cover a core set of essential health benefits, giving you confidence that your plan will cover key medical services.

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These benefits include:

• Preventive care services, like check-ups and screenings, at no extra cost.

• Emergency services.

• Prescription drugs.

• Maternity and newborn care.

 

The ACA put in place key protections to ensure fair and comprehensive coverage for everyone.

• No denials for pre-existing conditions: Health insurance companies can no longer deny you coverage or charge you more based on a pre-existing health condition.

 

• Coverage for young adults: Young adults can stay on a parent’s health insurance plan until age 26.

 

• No lifetime limits: Insurers are banned from imposing lifetime dollar limits on your coverage for essential health benefits.

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Ready to find your plan?

Choosing the right plan involves considering your health needs, financial situation, and preferred doctors. Schedule your no-cost consultation today!

© 2025 Standing Ovation Insurance. All rights reserved. 

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We do not offer every plan available in your area. Any information we provide is limited to the plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options or your local State Health Insurance Program (SHIP) to get information on all of your options. This website is a proprietary site and is not endorsed, associated, or authorized by the Social Security Administration, the Center for Medicare and Medicaid Services, or the Department of Health and Human Services. This site contains information about Medicare, services for people with Medicare, and services related to Medicare for decision-making purposes. If you would like to find out more information about the Medicare program, please visit the official US Government site for people with Medicare located at https://www.medicare.gov/.
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