Frequently asked questions.

Absolutely. You don’t need to choose a plan before reaching out. Tell us what you’re trying to understand, and a licensed insurance agent can talk through your options. Calling us or sending a message does not enroll you, change your coverage, or obligate you to buy a plan.

We can help you understand available options we offer in your area, including monthly premiums, costs when you receive care, doctor networks, and prescription coverage. Plan availability varies by location. Ask which insurers and plans an agent represents, and review the plan’s official documents before deciding.

Your state, the people who need coverage, and your main questions are a good start. A list of preferred doctors and medicines can help with a later plan review. Please don’t put Social Security numbers, payment information, or detailed medical records in this website’s message form. Any application documents should be shared through the appropriate secure process.

You’re welcome to contact a licensed agent with questions about your coverage or next steps. For a claim decision, urgent coverage issue, ID card, or payment problem, contact your insurer using the number on your member card. The insurer makes benefit and claim decisions; an agent cannot guarantee an approval.

Marketplace health plans cover essential health benefits, such as doctor visits, hospital care, and prescription medicines. Covered services still follow the plan’s network, cost-sharing, and other terms. Marketplace plans cannot deny coverage or charge more because of a pre-existing condition. Explore Marketplace benefits ↗

Most people enroll during the annual Open Enrollment period. Outside that window, certain changes—such as losing qualifying coverage, getting married, or having a baby—may allow a Special Enrollment Period. Deadlines, effective dates, and documentation requirements depend on your circumstances and Marketplace. Check your state’s current rules before ending existing coverage. Check enrollment guidance ↗

You may qualify for a premium tax credit based on your expected household income, tax household, and other eligibility requirements. Access to certain other coverage can affect eligibility. Some applicants also qualify for lower out-of-pocket costs when choosing an eligible Silver plan. The Marketplace determines eligibility; savings and a specific premium are not guaranteed. Learn about current savings rules ↗

Update your Marketplace application promptly when your expected income, household, or access to other coverage changes. Those changes can affect your savings. If you use advance premium tax credits, you must reconcile them on your federal tax return; you may have to repay excess amounts. A tax professional can help with your individual tax questions. Read the IRS guidance ↗

Yes, eligible self-employed people can apply for individual or family Marketplace coverage. An application uses your expected net self-employment income and other household income for the coverage year. If earnings vary, estimate carefully and update the Marketplace as your expectations change. Contact a licensed agent to discuss your individual coverage options.

HMO and EPO plans generally focus coverage on their provider networks, with exceptions such as emergency care. PPO plans generally allow out-of-network care at a higher cost. Referral rules and covered services vary. Before choosing, verify your doctors, hospitals, pharmacies, and medicines with the specific plan for the coverage year. Compare network types ↗

Look at the full picture: the premium, deductible, copays, coinsurance, and out-of-pocket limit for covered in-network services. Also check provider access and prescription costs. A lower premium can come with higher costs when you need care. The plan’s Summary of Benefits and Coverage helps you compare these details.

Start before your expected eligibility date, often around age 65. Some people qualify earlier because of disability or certain conditions. Whether you’re already receiving Social Security benefits and whether you have current employment-based coverage can affect enrollment steps and timing. Don’t assume you’ll be enrolled automatically or that delaying is penalty-free. Review Medicare enrollment guidance ↗

Original Medicare includes Part A for hospital insurance and Part B for medical insurance. Part D helps cover prescription medicines. Medicare Advantage, also called Part C, is a private-plan alternative that provides Part A and Part B benefits and usually includes Part D. Costs, networks, and extra benefits vary. Medigap supplements Original Medicare; it is different from Medicare Advantage. Understand the parts of Medicare ↗

Medicare is a federal program mainly for people 65 or older and certain younger people. Medicaid is administered by states under federal requirements, with eligibility based on income and other factors. Some people qualify for both. If you may qualify for Medicaid, contact your state Medicaid office for an official eligibility decision and application assistance. Find your state Medicaid office ↗

Check the specific policy. Adult routine dental and vision care may require separate coverage. Original Medicare generally does not cover routine dental care or routine eye exams for glasses, although certain medically necessary services are covered. Some Medicare Advantage plans include extra dental or vision benefits. Review benefit limits, networks, waiting periods, and exclusions before enrolling.

No. Our guide offers general information, and our forms let you request contact. They do not confirm eligibility, quote a guaranteed price, or submit an insurance enrollment. For ACA or Medicare questions, contact a licensed insurance agent. For Medicaid eligibility and enrollment, contact your state Medicaid office.