Affordable Care Act (ACA)
Health Coverage Before Medicare Begins
Not everyone who reaches out to us is already eligible for Medicare. If you’re under 65, retiring early, self-employed, or recently lost employer coverage, an Affordable Care Act (ACA) plan may be the right solution for you.
ACA plans, sometimes called Marketplace or “Obamacare” plans, provide comprehensive health coverage for individuals and families who don’t yet qualify for Medicare. They’re designed to offer meaningful protection, predictable costs, and financial assistance based on income.
Who ACA Coverage Is Designed For
ACA plans are typically a good fit for individuals who are not yet 65 and do not have access to employer-sponsored coverage. Many people use ACA coverage when they retire early, transition between jobs, or move into self-employment. It’s also a common option for couples where one spouse is eligible for Medicare and the other is not.
If you’re in that in-between stage, not quite ready for Medicare but no longer covered through work, ACA coverage can help bridge the gap.
What It Covers
All ACA plans are required to include essential health benefits. That means coverage for hospital stays, doctor visits, emergency services, prescription drugs, preventive care, and mental health treatment. Importantly, ACA plans cannot deny coverage due to pre-existing conditions.
Plans are organized into metal levels — Bronze, Silver, Gold, and Platinum — which determine how costs are shared between you and the insurance company. Some plans have lower monthly premiums with higher out-of-pocket costs, while others have higher premiums but lower costs when you receive care.
When You Can Enroll
ACA plans are available during the annual Open Enrollment Period, which typically runs from November through January. However, certain life events, such as losing employer coverage, moving, getting married, or having a child, may qualify you for a Special Enrollment Period outside of that window.
If you’re unsure whether you qualify, we can help you determine your eligibility and timeline.
If you’re approaching 65, the timing between ACA coverage and Medicare enrollment is important. Enrolling in the wrong coverage at the wrong time can create penalties or gaps. We’re happy to help you sort through those details and make sure you’re covered appropriately.
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© 2026 The MacCalla Agency. All rights reserved. As a national Medicare brokerage, we work with multiple carriers to provide comprehensive plan options. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.