Finding the Right Coverage Starts Here
If you are under age 65 and need health insurance, there are several coverage options available. Choosing the right plan depends on your healthcare needs, budget and whether you qualify for financial assistance.
Marketplace (ACA) Plans
Available Through the MarketplaceAlso known as Affordable Care Act (ACA) or Marketplace plans, these policies are available through the Health Insurance Marketplace. Many individuals and families qualify for premium tax credits and cost-saving subsidies based on household income and eligibility requirements.
Benefits may include
- Comprehensive health coverage
- Coverage for pre-existing conditions
- Preventive care services
- Access to premium tax credits for qualified applicants
We can help determine whether you qualify and guide you through the enrollment process.
Off-Marketplace Plans
Direct From Participating CarriersIf you do not qualify for Marketplace subsidies or prefer alternative coverage options, you may purchase health insurance directly through participating insurance carriers.
Off-Marketplace plans can provide
- Flexible plan options
- Multiple carrier choices
- Various deductible and premium levels
- Coverage tailored to your healthcare needs
We will help you compare available plans and select coverage that fits your situation.
The Affordable Care Act
The Affordable Care Act (ACA) was designed to expand access to health insurance coverage and protect consumers. Under the ACA:
- Coverage cannot be denied due to pre-existing conditions
- Premiums cannot be based on your health status
- All Marketplace plans include essential health benefits
- Financial assistance may be available for eligible individuals and families
Open Enrollment
The annual Open Enrollment Period generally runs from November 1 through January 15 in most states. Outside of Open Enrollment, you may qualify for a Special Enrollment Period if you experience a qualifying life event such as:
- Marriage
- Divorce
- Birth or adoption of a child
- Loss of employer coverage
- Relocation
Financial Assistance
Depending on your household income and family size, you may qualify for premium tax credits that can significantly reduce your monthly health insurance costs.
Understanding Your Options
Health insurance helps protect you from unexpected medical expenses while providing access to preventive care and essential healthcare services. Benefits include protection from high medical costs, access to preventive care, coverage for illnesses and injuries, ongoing care for chronic conditions and peace of mind for you and your family. Many preventive services are covered at no additional cost when received from participating providers.
What Every ACA Plan Includes
All ACA-compliant individual and small-group health plans include a core set of Essential Health Benefits.
Outpatient Care
Medical services received without being admitted to a hospital.
Emergency Services
Coverage for emergency room visits and emergency care.
Hospitalization
Inpatient hospital stays, surgeries and related services.
Maternity & Newborn Care
Coverage before, during and after pregnancy.
Mental Health & Substance Use Services
Behavioral health treatment, counseling and related services.
Prescription Drug Coverage
Coverage for approved prescription medications.
Rehabilitation & Habilitation Services
Services that help individuals recover or develop daily living skills.
Laboratory Services
Diagnostic testing and lab work.
Preventive & Wellness Services
Preventive care, screenings and chronic disease management.
Pediatric Services
Coverage for children’s healthcare needs, including dental and vision benefits.
What Affects Your Premium
Several factors may affect the cost of your health insurance coverage.
Factors That May Affect Premiums
- Age
- Geographic location
- Family size
- Tobacco use
- Plan level (Bronze, Silver, Gold, Platinum)
Factors That Do Not Affect Premiums
Under ACA Rules- Health status cannot impact pricing
- Pre-existing conditions cannot impact pricing
- Gender cannot impact pricing
Let us help you find the right individual plan
We will help you compare Marketplace and off-Marketplace options, check whether you qualify for financial assistance and enroll with confidence. Reach out for a no cost conversation.
