Resources & FAQs

Many Americans qualify for Advanced Premium Tax Credits (subsidies) based on household income. If your income falls between 100-400% of the federal poverty level, you likely qualify for financial assistance. We'll help you determine your eligibility during your free consultation.

You can still enroll if you qualify for a Special Enrollment Period (SEP). Common qualifying events include losing other coverage, getting married, moving, or having a baby. You must apply within 60 days of the event. If you don't qualify for an SEP, you'll need to wait until the next Open Enrollment period.

Open Enrollment typically runs from November 1 to January 15 each year. However, you may qualify for Special Enrollment if you've experienced a qualifying life event such as losing other coverage, moving, getting married, or having a baby.

Most clients are enrolled within 7-10 days from their initial consultation. The process involves three main conversations: a discovery call (15-30 minutes), plan review (30-45 minutes), and application submission (45-60 minutes).

Yes! We're certified enrollment partners. The plans and prices are identical to Healthcare.gov, but we provide free personal assistance to help you navigate your options and complete enrollment. There's no additional cost to use our services.

Subsidy eligibility is based on your household income and size. If your income falls between 100-400% of the federal poverty level, you likely qualify. During your consultation, we'll calculate your exact subsidy amount and show you how it affects your monthly premium.

You must report income changes to Healthcare.gov within 30 days. Income increases may reduce your subsidy, while decreases may increase it. At tax time, you'll reconcile your actual income with estimated income - you may owe money back or receive a refund.

Yes! If you qualify for a Silver plan, you may also be eligible for cost-sharing reductions (CSRs), which lower your deductibles, copays, and coinsurance. We'll help you identify all cost-saving opportunities you qualify for.

Contact us immediately. We can explore alternative plans, verify you're receiving all subsidies you qualify for, or help you apply for Medicaid if you're eligible. Don't let coverage lapse - we'll find a solution together.

Only if your actual income was higher than you estimated when you enrolled. If your income was lower, you may receive an additional refund. Reporting income changes throughout the year helps minimize surprise payments or refunds.

Most ACA Marketplace plans offer a network of doctors and hospitals. You can choose plans that include your preferred healthcare providers. We'll help you compare plan networks during enrollment to ensure your doctors are covered.

Under the ACA, insurance companies cannot deny coverage or charge higher premiums based on pre-existing conditions. Everyone pays the same rate regardless of health history. All ACA plans cover essential health benefits, including treatment for pre-existing conditions.

Emergency coverage works nationwide. For non-emergency care, it depends on your plan type: HMO plans usually have no out-of-state coverage except emergencies, PPO plans often have out-of-state networks, and EPO plans have limited out-of-state options. Always check your plan documents before traveling.

Insurance carriers typically provide a grace period: the first 30 days coverage continues and claims are paid normally; days 31-60, claims are paid but you'll owe back premiums; day 61+, coverage may be terminated and claims denied. Always contact your carrier immediately if you're having payment difficulties.

Call your insurance carrier's customer service or use their online provider directory. You can also contact us - we'll help you find in-network specialists and understand any referral requirements your plan may have.

An EOB is a statement from your insurance company showing what they paid for a service and what you owe. It's not a bill, but it helps you understand your coverage and verify billing accuracy. If you have questions about an EOB, we're here to help explain it.

Generally, you can only switch during Open Enrollment (Nov 1 - Jan 15) or if you qualify for a Special Enrollment Period. However, if you have Medicaid or CHIP, you can usually change plans monthly. Contact us to discuss your specific situation.

Getting employer-sponsored insurance is a qualifying life event that allows you to cancel your marketplace plan. Make sure your new coverage has started before canceling your current plan to avoid gaps in coverage.

Yes, but usually only during Open Enrollment or within 60 days of a qualifying life event (marriage, birth, adoption, divorce). Contact us as soon as your household changes so we can update your coverage promptly.

Contact Healthcare.gov or your insurance carrier directly. You can also call us and we'll assist with the cancellation process. Make sure you have other coverage in place before canceling to avoid gaps.