Do I have to enroll in healthcare benefits?

As part of the Affordable Care Act of 2010 (also called Obamacare), all Americans were required to have medical insurance or pay a tax penalty. This was commonly called the "individual mandate." 

As of 2019, the Tax Cuts and Jobs Act effectively zeroed out the tax penalty at the federal level. However, these states have individual mandates at the state level:

  • California
  • Massachusetts
  • New Jersey
  • Rhode Island
  • Vermont
  • Washington D.C.

Affordable Care Act Essential Benefits

The Affordable Care Act (ACA) defines benefits that must be included in health plans:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs. Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including dental and vision care

Coverage Rights & Protections

The ACA includes these core consumer provisions:

  • Requires insurance plans to cover people with pre-exisiting conditions without charging more
  • Free preventive care
  • Ending lifetime & yearly limits
  • Child coverage through 26
  • View all Rights & Protections Under the ACA

Affordable Care Act (ACA)

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