For many individuals and families in Wisconsin, securing affordable healthcare coverage can be a challenge. Fortunately, the Affordable Care Act (ACA) offers a solution that provides comprehensive health insurance options at prices that fit your budget. This educational guide is designed to help you understand ACA insurance, who qualifies, and how to apply for the right plan in Wisconsin.

What is ACA Insurance?
ACA insurance, also known as “Obamacare,” is a set of health insurance plans available through the Health Insurance Marketplace. These plans are designed to make healthcare accessible to all, regardless of pre-existing conditions or income levels. ACA plans must cover essential health services, such as:

• Preventive care (annual check-ups, screenings, vaccinations)
• Hospitalization and emergency care
• Prescription medications
• Mental health and addiction services
• Maternity, newborn, and pediatric care

The ACA ensures that no one can be denied coverage due to pre-existing conditions, and it provides financial assistance to make premiums and out-of-pocket costs more affordable for individuals and families in Wisconsin.

Who Qualifies for ACA Insurance in Wisconsin?
ACA insurance is available to nearly all residents in Wisconsin. It’s especially helpful for those who:

• Don’t have access to employer-sponsored health insurance
• Are self-employed or freelancers
• Have pre-existing medical conditions that may otherwise lead to high premiums
• Are currently uninsured or underinsured
• Are not eligible for Medicaid or Medicare

By applying for ACA insurance, you can access comprehensive healthcare coverage that meets your medical needs while remaining affordable.

Understanding ACA Subsidies and Financial Assistance
A major benefit of ACA insurance is the financial assistance it provides. Two types of subsidies are available for those who qualify:

1. Premium Tax Credits: These credits reduce the cost of your monthly premiums. The amount you receive is based on your income and family size, and it can significantly lower your out-of-pocket expenses for insurance coverage.

2. Cost-Sharing Reductions (CSRs): For individuals and families with lower incomes, CSRs help reduce the amount you pay for deductibles, co-pays, and other out-of-pocket costs. This makes it easier to afford healthcare services when you need them.

These subsidies ensure that ACA insurance is accessible to everyone, regardless of their financial situation.

Special Enrollment Periods in Wisconsin
While the standard open enrollment period typically runs from November to December, Special Enrollment Periods (SEPs) are available for individuals who experience certain life events. Qualifying events for SEPs include:

• Loss of job-based coverage
• Birth or adoption of a child
• Marriage or divorce
• Moving to a new state or region

If you qualify for a SEP, you can apply for ACA insurance at any time of the year, ensuring that you always have access to affordable healthcare coverage.

How to Enroll in ACA Insurance in Wisconsin
Enrolling in ACA insurance is straightforward, but it’s important to have expert guidance to ensure you choose the best plan for your needs. Mantis Health can help you navigate the process by:

• Comparing different plan options based on your healthcare needs and budget
• Determining your eligibility for premium subsidies and CSRs
• Ensuring you meet all enrollment deadlines
• Providing ongoing support for any questions you may have about your coverage

By working with Mantis Health, you can secure affordable, comprehensive healthcare coverage for yourself and your family in Wisconsin.