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Common Questions

What is the ACA? President Obama signed the Affordable Care Act (ACA) on March 23, 2010. It is a wide-ranging federal law that includes insurance, payment and delivery reform. The law establishes "exchanges" for people who cannot access health insurance through their employer, creates new rules for what insurance plans have to cover and how much they can charge, and provides support for people who cannot afford health insurance coverage.

What's the cost?

The cost is how much you will pay to be on a health plan: generally it is a combination of the monthly premium, the annual deductible and any uncovered expenses you might incur. The number itself will depend on which plan you qualify for. Consumers will be able to compare different health insurance plans and buy insurance in a variety of ways through the Exchange.

What's the coverage?

Coverage is the amount that your health plan will pay for when you go see a doctor or need to buy prescriptions. There are varying levels of coverage in the Exchange, with the difference being how much you pay versus how much your health plan will pay.

Who is making the offer?

New Mexico's Exchange is a publicly accountable organization, governed by a 12-member board that includes representatives from political parties, the health insurance industry and consumer advocates.

Are pre-existing conditions covered?

Yes. If you meet the eligibility requirements, the ACA requires individuals with pre-existing conditions (ranging anywhere from allergies to pregnancy) to have access to health insurance, without being charged higher premiums.

What doctors and hospitals can I access?

Health insurance plans have networks of hospitals, doctors, specialists, pharmacies, and other health care providers. Networks include health care providers that the plan contracts with to take care of the plan's members. Depending on the type of policy you buy, care may be covered only when you get it from a network provider.