Denied Coverage, Pre-Existing Conditions, and New to Florida
What if my health plan denies coverage for a service?
You have the right to appeal the decision. We help you understand the denial letter and file an internal or external appeal to request a review.
How can I find the right plan for pre-existing conditions?
All ACA plans must cover pre-existing conditions without charging more. We compare plans for drug coverage, specialist access, and chronic care.
Do health plans cover urgent care visits?
Yes, most plans cover urgent care visits at lower copays than ER visits. We help you find plans with convenient local urgent care options.
What’s the difference between Medicare Advantage and Medigap?
Medicare Advantage combines Medicare into one plan with extra benefits, while Medigap supplements Original Medicare to cover out-of-pocket costs. We compare both.
Can I get health insurance if I just moved to Florida?
Yes. Moving to a new ZIP code is a qualifying life event that allows you to enroll in a new plan through a Special Enrollment Period.
Can undocumented immigrants get health insurance?
Undocumented immigrants are not eligible for ACA plans but can purchase private health plans or short-term medical insurance. We explain available options.
What is coinsurance vs. a copay?
Copay: Fixed fee per service (e.g., $30 for a visit)
Coinsurance: You pay a percentage of the service cost (e.g., 20%)
Are birth control and women’s health covered?
Yes. ACA-compliant plans cover contraceptives, wellness visits, and maternity care as part of essential benefits for women.
What happens if I miss Open Enrollment and don’t qualify for special enrollment?
You may have to wait until the next Open Enrollment unless you qualify for Medicaid or buy a short-term plan to fill the gap.
Can you help with vision plans for adults?
Yes. We offer standalone vision insurance for eye exams, glasses, and contacts. These can be added to or bought separately from health plans.
Are prescription delivery services covered?
Many plans now include mail-order pharmacy services, which allow you to receive 90-day prescriptions with free shipping. We confirm availability.
What is balance billing?
Balance billing happens when an out-of-network provider bills you for the difference between what they charge and what your insurer pays. We help you check provider networks and understand your protections.
How do I report suspected insurance fraud?
You can report suspected fraud to the Florida Department of Financial Services or your health insurance company. We guide you through the process if needed.
Do insurance plans cover COVID-19 testing and vaccines?
It depends on your plan. The federal rule that required no-cost COVID-19 testing ended with the public health emergency, so coverage and costs for testing, vaccines, and treatment can vary. Check your plan’s details, or ask us and we’ll look it up.
What if I turn 26 and lose coverage under my parent’s plan?
Turning 26 qualifies you for a Special Enrollment Period. We help you get your own ACA plan with or without subsidies.
Are there health insurance plans for cancer patients?
Yes. We help individuals with cancer find plans that cover oncology care, prescriptions, specialists, and cancer treatment centers.
What’s a good health plan for freelancers?
We recommend ACA or private plans with flexibility and low out-of-pocket maxes. HSAs are also a good fit for self-employed individuals.
Do plans cover rehabilitation and physical therapy?
Yes. Most ACA plans include rehab, PT, and occupational therapy under essential health benefits. We confirm exact coverage amounts.
What are your hours of operation?
Our team is available Monday–Friday, 9:00 AM–5:00 PM ET. You can also contact us online 24/7 for quotes or questions.
Can I get same-day health insurance coverage?
Same-day coverage isn’t available for Marketplace plans. Applications are often approved within 24 hours, and coverage can start as soon as the 1st of the month. We’ll help you get your application in quickly.
Creative Health Solutions