Frequently Asked Questions
What are insurance prices based on?
Public ACA Marketplace (aka Obamacare plans) are based on income and age. If your income increases, so will your premiums. Private plans are based on health and only increase 2-5% every renewal to keep up with your age. If you don’t qualify for government assistance through the Public Marketplace, and you’re relatively healthy, you can leverage your good health to qualify for better benefits at a more affordable price!
When is the Open Enrollment period for the Public ACA Marketplace?
The Open Enrollment period is November 1st-January 15th. Outside of the Open Enrollment period, you must have a Qualifying Life Event (change of address, loss of coverage, change in family members) to sign up for a Public ACA Marketplace plan.
Do I only have the Open Enrollment time period to be able to set up private insurance?
Open enrollment is specific to Public ACA Marketplace plans. Private insurance is available year-round!
Can I sign up for the ACA/Public Marketplace outside of the Open Enrollment period?
To enroll in an ACA/Public Marketplace plan, you must have a Qualifying Life Event (QLE). Examples of a QLE include: Loss of Health Coverage (such as losing existing health coverage including job-based, individual, and student plans, losing eligibility for Medicare, Medicaid, or CHIP, or turning 26 and losing coverage through a parent’s plan), Change in Household (getting married or divorced, having a baby or adopting a child, death in the family), Change in residence (moving to a different ZIP code or county, a student moving to or from the place they attend school, a seasonal worker moving to or from the place they both live and work, or moving to or from a shelter or other transitional housing).
What are the biggest differences between Public ACA Marketplace Plans and Private Insurance?
The Public ACA Marketplace is guaranteed issue major medical coverage , which means individuals cannot be denied for pre-existing conditions. It is most affordable IF you qualify for a government subsidy with monthly premiums. If you do not qualify for a subsidy, it is more expensive than most other available plans.
Private insurance is health-based, so there is an application process because not everyone may qualify based on health. If you are healthy, you can get preferred rates that are less costly than most plans, with BETTER coverage.
What are the differences between EPO, HMO, and PPO Coverage?
EPO and HMO networks have health coverage that is limited to your county, so if you are traveling outside of your local area, your benefits would be significantly limited for out-of-network coverage. EPO’s DO NOT require a referral to visit a physician/specialist. HMO’s DO require a referral from your primary care physician to use a specialist, such as a cardiologist or a dermatologist. The Public ACA Marketplace is limited to health coverage plans on an HMO or EPO network.
A PPO Network allows you nationwide coverage with no referral required for a physician, including specialists. Regardless of what county or state you may be in, your benefits are applicable! We have access to private and group plans on one of the largest PPO Networks.
What is the fee for your services?
We do not charge a fee for services. We are happy to help with answering questions or offering guidance, in any way that we can.