Health insurance, explained
Answers to the questions we hear most.
Clear, fact checked answers with the source linked at the bottom of each one. Tap any question to expand it on your phone or computer.
When can I enroll in a Marketplace plan?
Open Enrollment runs November 1 to January 15 every year. Outside that window you can still enroll if you have a qualifying life event, which opens a 60 day Special Enrollment Period. Answer the quick form and I will tell you which window applies to you.
Source: HealthCare.gov
What counts as a qualifying life event?
Common qualifying events include losing employer coverage, moving to a new area, getting married or divorced, having a baby or adopting a child, turning 26 and leaving a parent plan, or a change in household income. Most events open a 60 day window to enroll.
Source: HealthCare.gov
Can I be denied for a medical condition I already have?
No. Every ACA Marketplace plan must cover treatment for pre existing medical conditions. No plan can reject you, charge you more, or refuse to pay for essential health benefits because of a condition you had before your coverage started.
Source: HealthCare.gov
Do I qualify for a $0 or low cost plan?
Many people do. Premium tax credits are based on your estimated household income and family size, and in some cases they can bring your monthly premium down to $0. If you choose a Silver plan, you may also qualify for savings that lower your deductible and copays.
Source: HealthCare.gov
What are the Bronze, Silver, Gold, and Platinum tiers?
Metal tiers show how you and the plan share costs. Bronze plans pay about 60% of covered costs, Silver 70%, Gold 80%, and Platinum 90%. Silver plans also unlock extra savings for people who qualify based on income.
Source: HealthCare.gov
Are the prices the same as on HealthCare.gov?
Yes. As a licensed broker I quote the exact same ACA plans and premiums you would find on the federal Marketplace. The plan price is filed by the carrier and approved by the state, so it is identical whether you enroll on your own or with a broker.
Source: HealthCare.gov
Will I pay more by using a broker?
No. You will not pay anything additional to enroll with a licensed agent or broker. Brokers are paid by the insurance carriers, not by you, and your plan premium stays the same. You simply get free help with enrollment, claims, and yearly reviews.
Source: HealthCare.gov
What is the difference between ACA and private PPO?
ACA Marketplace plans are guaranteed issue and come with income based subsidies. Private PPO plans are sold outside the Marketplace and often offer wider doctor networks, but they do not come with subsidies. I will show you both side by side so you can compare total cost against network access.
Source: HealthCare.gov
Which states are you licensed in?
We are licensed and helping clients across more than 45 states. Enter your ZIP code in the quote form and we will confirm the best carrier options available where you live.