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Diana Kelley: (520) 907-3664

Terry Ansley:  (520) 907-5132

Contact us today for your NO COST insurance review!

Marketplace Health Insurance (Under 65)

Health Insurance Plans for Individuals and Families

This includes Health Insurance plans for Individuals and Families, under the age of 65, who don’t have the option of group health insurance coverage through an employer. 

WHAT IS MARKETPLACE INSURANCE?

The Marketplace insurance refers to the Health Insurance Marketplace, also known as the Health Insurance Exchange. It is a service that helps people shop for and enroll in affordable health insurance. The Marketplace was created under the Affordable Care Act (ACA) and is designed to provide a way for individuals, families, and small businesses to find health insurance coverage, particularly for those who don’t have access to employer-sponsored insurance.

Key Features of Marketplace Insurance

  1. Plans Available: The Marketplace offers a variety of health insurance plans, categorized by metal tiers (Bronze, Silver, Gold, Platinum) based on the amount of coverage and costs, such as premiums, deductibles, and out-of-pocket expenses

  2. Financial Assistance: Based on income, individuals and families may qualify for subsidies to help lower the costs of insurance, such as:

    • Premium tax credits to reduce monthly premiums

    • Cost-sharing reductions to lower out-of-pocket costs (e.g., copays, deductibles) for eligible individuals

  3. Eligibility: Marketplace insurance is available to U.S. citizens and legal residents who don’t have access to affordable employer-based insurance, Medicare, Medicaid, or other public insurance programs. Income limits apply to qualify for financial assistance

  4. Open Enrollment Period: People can sign up for or change their Marketplace insurance plans during specific periods (usually once a year during the Open Enrollment Period). Outside of this period, you can only apply if you qualify for a Special Enrollment Period due to life events such as marriage, childbirth, or loss of job

  5. State or Federal Marketplace: Depending on where you live, the Marketplace may be run by the federal government (Healthcare.gov) or by individual states through their own state-based exchanges

Marketplace insurance provides a way for you to access health coverage that meets ACA requirements, with the added benefit of financial assistance for qualifying individuals and families.

WE WILL ASSIST YOU WITH THE FOLLOWING

1. Understand Your Needs

  • Assess Your Situation: Understand your personal situation, including income, family size, health needs, and any existing coverage

2. Research Insurance Options

  • Compare Plans: Research different insurance providers and plans that match your needs and budget

3. Explain Coverage and Costs

  • Clarify Terms: Help you understand key insurance terms (premium, deductible, copay, out-of-pocket max, network, etc.)

  • Compare Costs and Benefits: Ensure you understand the trade-offs between monthly premiums, deductibles, and coverage options

4. Assist with Application Process

  • Online Enrollment: Guide you through the online application process (via the insurance provider's website or a government exchange, if applicable)

  • Paperwork: Help you gather the necessary documentation, such as proof of income, residency, and identity, if required

  • Fill Out Forms: Assist in completing any necessary forms, whether online or on paper

5. Follow Up and Finalize Enrollment

  • Verify Coverage: Once enrolled, confirm your coverage is active and that you understand how to use your insurance

  • Help Setup Payment: Ensure that your premium payments are set up to avoid coverage gaps

  • Review Renewal: Remind you to review and renew your policy before the next open enrollment period

By understanding your individual needs, comparing insurance options, explaining key details, and assisting you through the application process, we will help you successfully enroll in insurance.

WHEN CAN YOU APPLY?

1. Open Enrollment Period (OEP)

  • This is the main time each year when you can apply for or change your health insurance plan through the Marketplace

  • The dates for the Open Enrollment Period vary each year. The Open Enrollment Period runs from November 1 to January 15

  • If you enroll by December 15, your coverage will begin on January 1. If you enroll after this date, your coverage will start on February 1

  • During this time, you can apply for new coverage, switch plans, or renew your current plan

2. Special Enrollment Period (SEP)

  • You can apply for Marketplace insurance outside of Open Enrollment if you experience certain life events. These events trigger a Special Enrollment Period, allowing you to apply for coverage or change plans

  • Examples of qualifying life events include:

    • Losing other health coverage (e.g., losing employer-based insurance, aging off a parent's plan)

    • Getting married or divorced

    • Having a baby or adopting a child

    • Moving to a new state

    • Becoming a U.S. citizen or lawfully present

    • Changes in income that affect eligibility for subsidies

  • Typically, you have a 60-day window after the life event to apply for or change your Marketplace insurance

Easily search for and find affordable individual or family health plans

or

Easily search for and find affordable individual or family health plans

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Contact us now for your NO COST insurance review!

Diana: (520) 907-3664

Terry: (520) 907-5132

Hours:

Monday - Friday:  9am - Flexible

Saturday - Sunday:  9am - Flexible

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