Marketplace Health Insurance

You can get health insurance during open enrollment or by qualifying for a special enrollment with the marketplace. 

Open enrollment on the federal Health Insurance Marketplace runs from November 1 through January 15. Enroll by December 15 for coverage that starts January 1. During this time, you can enroll in a new health insurance plan or make changes to your existing plan. It’s important to mark your calendar and take action during this period to ensure you have coverage for the upcoming year.

Important Dates: 

• November 1: Open Enrollment begins for health coverage for the upcoming plan year, marking the first opportunity to enroll in, renew, or modify health plans through the Marketplace. Coverage can commence as early as January 1.
• December 15: Deadline for enrolling in or making changes to plans to ensure coverage starts on January 1.
• January 1: Commencement of coverage for individuals who enrolled in or modified plans by December 15 and paid their initial premium.
• January 15: Conclusion of Open Enrollment—final day for enrolling in or modifying health plans for the year. Subsequent enrollment or plan changes are only permissible if qualifying for a Special Enrollment Period.
• February 1: Start of coverage for individuals who enrolled in or modified plans between December 16 and January 16, and completed payment of their initial premium.

Qualifying life events typically permit a Special Enrollment Period with the health insurance marketplace. These events may include:

1. Loss of existing health coverage (e.g., job loss, aging out of a parent’s plan).
2. Changes in household (e.g., marriage, divorce, birth, adoption).
3. Relocation to an area with different health coverage options.
4. Gaining citizenship, leaving incarceration, or leaving a residential institution.
5. Certain changes in income or household status that affect eligibility for premium tax credits or cost-sharing reductions.
6. Certain incomes compared to household will qualify individuals or families for a special enrollment.

These are some common examples, but specific eligibility criteria may vary. It’s essential to review the marketplace’s guidelines or consult with a qualified healthcare representative to determine eligibility for a Special Enrollment Period.

The best health insurance for you depends on your needs, budget, and personal circumstances. To find the right plan, consider factors like your health status, medical needs, preferred doctors and hospitals, and financial situation. It’s also essential to understand the types of plans available, such as HMOs, PPOs, and high-deductible plans, and compare their coverage, costs, and benefits. Working with an insurance advisor can help you navigate your options and find a plan that meets your requirements.

• All Marketplace plans cover these 10 essential health benefits:

Outpatient care (doctor visits without hospital admission)

Emergency services

Hospitalization (including surgeries and overnight stays)

Pregnancy, maternity, and newborn care

Mental health and substance use disorder services (including counseling)

Prescription drugs

Rehabilitative and habilitative services (to help with recovery)

Laboratory services

Preventive and wellness services (like screenings)

Pediatric services (including dental and vision care for children)

Health insurance is worth it when it helps cover the costs of medical care that you might not be able to afford on your own. It provides financial protection in case of unexpected accidents or illnesses, giving you access to necessary treatments without worrying about the high costs. Additionally, having health insurance can give you peace of mind knowing that you’re covered if you need medical care.

You should get health insurance as soon as possible to protect yourself from unexpected medical expenses. It’s especially important to have coverage before you need medical care. Marketplace plans cannot deny you coverage, charge you more, or refuse to pay for essential health benefits because of a pre-existing condition. Privately underwritten plans work differently: they can ask health questions and may limit or exclude coverage for a condition you already have. So, the sooner you enroll in a health insurance plan, the better prepared you’ll be for any healthcare needs that may arise.

Private health insurance is worth considering if you want more control over your coverage options and healthcare providers. It can be especially beneficial if you’re not eligible for government-subsidized plans or if you prefer a wider range of benefits and services. Additionally, private health insurance may offer more flexibility in choosing doctors and hospitals, as well as additional coverage options like dental and vision care. Ultimately, it’s worth it if you value choice and customization in your healthcare coverage.

Health insurance can be free if you qualify for a large premium tax credit based on your income & household size. There are government programs like Medicaid and the Children’s Health Insurance Program (CHIP) that provide free or low-cost health coverage to eligible individuals and families with low incomes. You can check if you qualify for these programs through your state’s Medicaid office.

We provide health coverage for individuals and families, accident insurance, dental and vision plans for individuals and groups, life insurance, and disability plans.

We simply get paid from whatever insurance company you choose. There is no cost to you associated with using an insurance agent or broker. 

The best plan for you simply depends on your budget, medical needs, prescription needs, and doctors/ hospitals you would like to use. Typically bronze plans have higher out of pocket expenses, while gold or platinum plans have less out of pocket expenses. If you can qualify for a premium tax credit then you would be able to get a higher level plan for a much cheaper cost.