What does "ACA compliant" mean?

To be considered "ACA-compliant," a health plan adheres to the regulations outlined in the Affordable Care Act. But what does this actually entail? In essence, individual and family policies that meet ACA standards provide coverage for the ten essential health benefits, without imposing any limits on annual or lifetime coverage.

The easiest way to know if a plan is ACA compliant is to shop for an individual/family policy from a federal or state-based exchange or marketplace. Plans included on the marketplaces are compliant and therefor qualified health plans.

Below are more specific details for ACA compliant individual/family health plans:

• Pre-existing conditions are covered, and medical underwriting cannot be used. This means you cannot be denied coverage for a medical issue and an insurance carrier cannot ask you a lot of questions about your health.
• Premiums can only be based on age, location, tobacco use, and the number of family members enrolling in coverage. That's it.
• Policies must cover the essential health benefits, with a cap on out-of-pocket costs for in-network care.
• Policies cannot impose annual or lifetime dollar limits on any essential health benefit.