Switching Plans and Understanding What You’ll Pay

Yes, but only if you qualify for a Special Enrollment Period due to a qualifying life event such as moving, marriage, or job loss.

A premium is the monthly amount you pay to keep your health insurance active, regardless of whether you use medical services.

Your out-of-pocket maximum is the most you’ll pay for covered services in a plan year. After you reach this amount, your insurance pays 100% of covered costs.

ACA plans are required to cover essential benefits and cannot deny coverage due to pre-existing conditions. Non-ACA plans (like short-term coverage) have fewer regulations and may not offer the same protections.

Yes, mental health and substance use disorder services are considered essential benefits under the ACA and are covered by all compliant plans.

We help you compare:

• Premiums

• Deductibles

• Copays & coinsurance

• Covered providers and prescriptions
  to find a plan that matches your needs and budget.

Yes. If your employer doesn’t provide coverage, we help part-time workers find affordable individual plans through the ACA or private marketplace.

Yes. Health Savings Account (HSA) funds can be used for qualified dental, vision, and medical expenses—even if your plan doesn’t include these benefits.

Catastrophic plans have low premiums and very high deductibles. They’re available to people under 30 or those with a financial hardship exemption.

Most plans offer a grace period (usually 30 days). Missing payments may lead to a loss of coverage. We help clients understand payment terms to avoid gaps.

Yes. Most insurers allow you to change your Primary Care Provider (PCP) at any time by logging into your member portal or calling customer service.

Some plans cover acupuncture, chiropractic, or physical therapy, especially when medically necessary. We help check if your preferred therapies are included.

As of 2019, there’s no federal penalty, but some states still charge a fee for being uninsured. It’s still smart to carry coverage to avoid high medical bills.

Yes. We provide bilingual support and help Spanish-speaking clients understand their coverage options and complete applications.

Essential health benefits are services all ACA plans must cover, including ER visits, maternity, mental health, prescriptions, and preventive care.

We guide you through cancelling or updating your existing plan, whether it’s through the marketplace, COBRA, or a private insurer.

Yes. Your household income affects your eligibility for subsidies, Medicaid, and ACA coverage. We help you estimate and update your income properly.

Yes. Health insurance protects you from unexpected costs like ER visits or accidents. Preventive services are also included, keeping you healthy long-term.

Yes. Most ACA plans cover lab work, blood tests, and diagnostic imaging, but coverage may vary. We confirm which services are included.

We help determine Medicaid eligibility and guide you through applying with the Florida Department of Children and Families (DCF).