Can I Have Critical Illness Insurance if I am on an Affordable Care Act (ACA) Plan?

What is the Affordable Care Act?

The Affordable Care Act (ACA) is a comprehensive health care reform law enacted in March 2010.¹ It has three primary goals, which are:¹

1. Making affordable major medical health insurance available to more people. The law provides for subsidies (“premium tax credits”) that lower health insurance costs for households with incomes between 100% and 400% of the poverty level.
2. Expanding the Medicaid program to cover adults with income below 138% of the federal poverty level. It’s important to note all states have expanded their Medicaid programs.
3. Supporting innovative medical care delivery methods designed to lower the costs of health care generally.

Costs generally include deductibles and coinsurance/copayments, but you should speak to your insurance company or a licensed insurance agent for any specific information, as it can vary.

What is critical illness insurance?

Critical illness does not provide major medical insurance coverage but provides supplemental insurance benefits for medical emergencies like heart attack, stroke, or cancer. Benefits can also be used to help cover non-medical related costs such as transportation, child care, etc.

Since these emergencies or illnesses often have high medical costs, some critical illness policies have a lump sum benefit to help cover costs where ACA coverage might not.

There are many policies available and their costs are typically relatively low. However, coverage limits vary and can be limited, so it’s important to review your policy carefully and consult your insurance company or a licensed insurance agent with any questions you may have.

Critical illness insurance and the ACA.

Critical illness policies can be used to supplement - not replace - major medical insurance coverage. They operate under state regulations. By understanding how the ACA works, it will help you learn how health insurance sold in the individual market can affect you and your loved ones. From there, you can determine whether it’s possible to get critical illness insurance.

To learn more specific information about critical illness policies and what a policy could cover for your specific situation, contact your insurance company or a licensed insurance agent.

Sources:
¹ healthcare.gov, Affordable Care Act (ACA), accessed August 2021