FREQUENTLY ASKED QUESTIONS

  • An Exclusive Provider Organization (EPO) plan is a type of health insurance that offers a network of providers but doesn't cover out-of-network care unless it's an emergency. It's typically more affordable than PPOs but less flexible.

  • A deductible is the amount you pay for covered healthcare services before your insurance plan starts to pay. Higher-deductible plans often have lower premiums.

  • If you enroll during Open Enrollment, coverage typically begins January 1. For Special Enrollment, it usually starts the first of the following month after your application is approved.

  • If you miss Open Enrollment, you can only sign up for health insurance if you qualify for a Special Enrollment Period due to life changes like marriage, birth, or loss of coverage.

  • We help you review your current plan and compare new options during Open Enrollment to ensure you're still getting the best value. Most plans renew automatically, but it’s best to recheck your eligibility for subsidies.

  • Yes. Under ACA rules, most plans cover preventive services like annual check-ups, vaccines, and screenings at no extra cost when done in-network.

  • It depends on the plan. PPOs usually offer better out-of-area coverage, while HMOs are more limited. We’ll find a plan that matches your travel needs.

  • Losing employer-sponsored insurance qualifies you for a Special Enrollment Period. You may also qualify for COBRA or ACA marketplace coverage. We help you evaluate all options.

  • Yes, children can remain on your plan until age 26 under ACA rules. After that, we help young adults find affordable student or individual health plans.

  • Most plans categorize medications into tiers (generic, brand-name, specialty) and assign a copay or coinsurance for each. We’ll check your prescriptions against plan formularies to minimize your costs.

  • Yes. You may qualify for federal subsidies, premium tax credits, or cost-sharing reductions based on income and household size. We verify eligibility for you.

  • We help clients with diabetes, asthma, heart disease, and other chronic illnesses find plans that cover their medications, doctor visits, and specialty care affordably.

  • A qualifying life event includes marriage, divorce, birth, adoption, losing job-based coverage, or moving. These trigger a Special Enrollment Period for health insurance.

  • Coinsurance is the percentage of medical costs you pay after meeting your deductible. For example, if your coinsurance is 20%, you pay 20% and the insurer pays 80%.

  • Yes, it’s called dual coverage. One plan is the primary payer, and the other is secondary. We help coordinate benefits so you don’t overpay.

  • Yes. All ACA-compliant plans include maternity and newborn care as essential health benefits. We help expectant parents find the right plan for prenatal care, labor, and delivery.

  • Yes. Many legal immigrants qualify for ACA marketplace plans and subsidies. We help determine eligibility and find plans that meet your needs.

  • Yes, short-term health insurance is available and provides basic coverage for up to 12 months. It’s ideal for coverage gaps but doesn't meet ACA standards.

  • Typically, vision care is not included in standard plans (except for children), but we offer affordable vision insurance add-ons for adults.

  • You can call us at (321) 872-4940, fill out our online quote form, or schedule a consultation. We’ll provide a free, no-obligation quote tailored to your needs.