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  • turned 26 health insurance

    Turned 26 

    Joe who just turned 26 years old and getting off his parents health insurance plan. Joe can check for eligibility to receive subsidy based on his income for the current year.

  • chnge income health insurance

    Change in Income

    Marcus recently had a change in income and needed to check for his Medicaid Eligibility.

  • lost coverage health insurance

    Lost Coverage

    Mary lost her employer’s coverage and she needs an equivalent coverage since she takes a prescription medication.

Who is this for?

Individuals and Families can apply for these ACA plans during open enrollment or Special Enrollment Period. You can filter plans that are accepted by your doctors and cover your prescriptions.

Qualifying Life Events that allow you to enroll in a health insurance plan

Birth / Adoption / Foster Care

You have 60 days to enroll or change your health insurance plan due to adoption. Please make sure to contact us within 60 days to make changes.

Marriage

You have 60 days from the date you get married to change, or enroll in a health insurance plan. You either choose to add your spouse to your health insurance coverage, get added to your spouse health insurance plan, or enroll in a new health insurance plan. Contact us within 60 days

Permanent Move

If you move to a new address within the same state or a different state you are qualified to change your health insurance plan based on a special enrollment period.

Loss of Coverage (due to COBRA)

You are eligible to enroll in a health insurance plan when you lose your COBRA coverage, end your COBRA coverage, or when COBRA expires. You have 60 days from the loss date to enroll in a health insurance plan.

ICHRA or QSEHRA

ICHRA and QSEHRA: If you are employer started to offer a health reimbursement arrangement, you are eligible to enroll in a health insurance plan. Contact us or your employer for more information.

protected

Consumer protections and benefits provided by the ACA include

  • Providing coverage for people with pre-existing conditions
  • Eliminating annual and lifetime dollar limits on health insurance coverage
  • Providing free preventive care
  • Allowing young adults to remain on their parents’ plans until they are 26 years old
  • Allowing people to compare health insurance coverage options before selecting a plan
  • Providing premium tax credits to people who qualify to help lower health insurance costs
  • Increasing access to Medicaid

Major Medical Coverage For ACA Plans

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Rehab Services

ACA health insurance plans offer coverage for rehab services such like: physical therapy. speech therapy, and behavioral therapy. Chiropractor visits are covered with limit on number of visits.

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Dental & Vision for Children

Dependent children under 19 years old have dental and vision coverage included in the health insurance plan. No additional premium is needed for this coverage. Adults must enroll in a separate dental and vision plan if they want coverage.

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Maternity & Newborn

Your ACA health insurance plan covers pregnancy pre-natal and post-natal visits. Labor and delivery and the newborn medical services. You can add your newborn to your plan as well after delivery.

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Pre-Existing Conditions

The health insurance plans offered on the marketplace follow the ACA rules where all pre-existing conditions are covered. The monthly premium is NOT calculated based on pre-existing conditions.

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Pre-Existing Conditions

The health insurance plans offered on the marketplace follow the ACA rules where all pre-existing conditions are covered. The monthly premium is NOT calculated based on pre-existing conditions.

What documents can I submit to verify income to marketplace?
  • 1040 federal or state tax return. Note: It must contain your first and last name, income amount, and tax year.
  • Wages and tax statement (W-2 and/ or 1099, including 1099 MISC, 1099G, 1099R, 1099SSA, 1099DIV, 1099SS, 1099INT). Note: It must contain your first and last name, income amount, year, and employer name (if applicable).
  • Pay stub. Note: It must contain your first and last name, income amount, pay period or frequency of pay with the date of payment. If a pay stub includes overtime, please indicate the average overtime amount per paycheck.
  • Self-employment ledger documentation (can be a Schedule C, the most recent quarterly or year-to-date profit and loss statement, or a self-employment ledger). Note: It must contain your first and last name, company name, and income amount. If you’re submitting a self-employment ledger, include the dates covered by the ledger, and the net income from profit/loss.
  • Social Security Administration Statements (Social Security Benefits Letter). Note: It must contain first and last name, benefit amount, and frequency of pay.
  • Unemployment Benefits Letter. Note: It must contain your first and last name, source/agency, benefits amount, and duration (start and end date, if applicable).
What documents can I submit for self employment income?
  • 1040 SE with Schedule C, F, or SE (for self-employment income)
  • 1065 Schedule K1 with Schedule E
  • Tax return
  • Bookkeeping records
  • Receipts for all allowable expenses
  • Signed time sheets and receipt of payroll, if you have employees
  • Most recent quarterly or year-to-date profit and loss statement
What documents can I use to confirm unearned income?
  • Annuity statement
  • Statement of pension distribution from any government or private source
  • Worker’s compensation letter
  • Prizes, settlements, and awards, including court-ordered awards letter
  • Proof of gifts and contributions
  • Proof of inheritances in cash or property
  • Proof of strike pay and other benefits from unions
  • Sales receipts or other proof of money received from the sale, exchange, or replacement of things you own
  • Interests and dividends income statement
  • Loan statement showing loan proceeds
  • Royalty income statement or 1099-MISC
  • Proof of bonus/incentive payments
  • Proof of severance pay
  • Pay stub indicating sick pay
  • Letter, deposit, or other proof of deferred compensation payments
  • Pay stub indicating substitute/assistant pay
  • Pay stub indicating vacation pay
  • Proof of residuals
  • Letter, deposit, or other proof of travel/business reimbursement pay

Achieved National Recognition

Recognized by CMS for helping more than 100 clients enroll in a Marketplace health insurance plan utilizing subsidies from Healthcare.gov.

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Work with a Licensed Agent

When you’re searching for a health insurance plan, it’s important to find a professional who can give you all the advice you need. A health insurance agent can advocate for you in negotiations with insurers, help you navigate through life changes, and help you re-shop during open enrollment. The regulations surrounding health insurance are changing all the time, and using a licensed agent is a much better choice. A licensed agent will be familiar with the various types of plans available and will know which ones are best for your needs.

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How It Works

As an independent broker we are able to provide you with insurance plans from different carriers. Compare benefits, check rates, and enroll.

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01

Tell Us About You

Enter your Zip Code, DOB, and Doctors you want In Network

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02

Review Available Plans

Review your savings eligibility and compare plans

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03

Enroll in a Plan

Congratulations. Your coverage will start the first day of the following month

Frequently Asked Questions

What is Affordable Care Act health insurance?

ACA health plans are designed to give health coverage regardless of pre-existing conditions. These plans are designed to offer premium subsidies that (Advanced Premium Tax Credit).

When Can I Sign Up for ACA Health Plan?

You can sign up for an ACA health plan during the Open Enrollment Period that runs from November 1st to December 15th. Otherwise, you can enroll during a Special Enrollment Period if you have a Qualifying Life Event.

How Many Days After a Qualifying Life Event do I have to Enroll in a Health Plan?

You have 60 days from the Qualifying Life Event to enroll in a health plan.

What is an out-of-network provider?

An out-of-network provider is a doctor, care professional (nurse practitioner, anesthesiologist, etc.) or facility (hospital, lab processing facility, ambulatory surgery center, etc.) that is not part of your health plan’s network.

Your health insurance plan negotiates with healthcare providers and facilities to provide services at lower rates, and that’s how doctors and hospitals become part of the network. Out-of-network providers do not have contracts with the health insurance company.

I have gone to an in-network hospital. All of the providers there are in network, right?

Not necessarily. For example, if you go to a network hospital to get an MRI, the doctor reading the MRI may not be in the network. That doctor may charge the full price for the service, not the lower negotiated rate allowed for a network provider.

What if I have an emergency?

In a true emergency, you should visit the nearest emergency room. If you receive emergency services from an out-of-network doctor or hospital, your costs may be more than they would be from a network provider. And, you may also be billed for the difference between what the provider charges and what your health insurance plan allows.

Best primary doctors that take Ambetter insurance

To find the best primary doctors that take Ambetter insurance, you can work with your insurance agent to research the health plan providers directory.

Individual health insurance broker near me

You can find an individual health broker by scheduling a call to speak an agent licensed in your state.

Do ACA plans cover Dental and Vision too?

Some ACA plans offer Dental and vision coverage for Adults and other do not. However, most ACA plans offer Dental and Vision coverage for kids until age 19.

How much does ACA health plan cost?

ACA health plans cost range based on many factors. Age and plan type (Bronze, Silver, and Gold) affects the rate. For example a Bronze plan have a high deductible and thus a low premium. However, you can find plans as low as $1 month.

Can I Sign Up All My Family Members on The Same Health Plan?

Yes. You can add your spouse and dependents (under 26 years old) to the same health plan. We encourage you to add all your dependents and check for subsidy.

What happens when I use an out-of-network hospital or provider?

Your out-of-pockets costs (like copayments, coinsurance, and deductibles) will be higher. That is because you are charged the full price for a service, and not the lower, negotiated rate you would pay through the health insurance plan network.

What is an allowable charge?

An allowable charge (sometimes called the allowed amount) is the amount the health insurance company allows for a covered health care service. Another term is “Maximum Allowable Fee”

What is balance billing?

Balance billing is when an out-of-network provider bills you for the difference int their charge and what the your health insurance plan will allow. For example, let’s say an out-of-network doctor charges $100 to review your MRI, but your plan will only allow for $70. The doctor may bill for the remaining $30 in addition to what you may owe for your deductible or coinsurance.

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We bring hundreds of different plans from multiple Insurance carriers to give our clients more options.

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Tell us about yourself and your insurance needs. We will provide quotes from various carriers for you to compare and choose from.

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