Traditional Health Insurance

A "qualified" major medical health plan is an insurance plan that’s certified by the Health Insurance Marketplace, provides essential health benefits, follows established limits on cost-sharing (like deductibles, copayments, and out-of-pocket maximum amounts), and meets other requirements under the Affordable Care Act.  All qualified health plans meet the Affordable Care Act requirement for having health coverage, known as minimum essential coverage.”

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Did You Know?

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What are the "10 Essential Health Benefits"

All Plans Offered in the Marketplace cover these "10 Essential Health Benefits"

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Hospitalization (like surgery and overnight stays)
  • Pregnancy, maternity, and newborn care (both before and after birth)
  • Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

    Additional benefits
  • Plans must also include the following benefits:
  • Birth control coverage
  • Breastfeeding coverage
  • Essential health benefits are minimum requirements for all Marketplace plans. Specific services covered in each broad benefit category can vary based on your state’s requirements. Plans may offer additional benefits, including:
  • Dental coverage
  • Vision coverage
  • Medical management programs (for specific needs like weight management, back pain, and diabetes).
What Does "Minimal Essential Coverage" Mean?

Examples of "Qualifying" Health Coverage

See a more detailed list of types of plans that do and don’t count as qualifying health coverage from the IRS.

When Can I Enroll?

Enrollment Guidelines

You can still get coverage outside of Open Enrollment in 2 ways:

SEE IF YOU CAN GET COVERAGE

If you don't have the need for expensive comprehensive coverage.  Take a look at some of these alternative options, clients are saving THOUSANDS of dollars a year!

Alternative Health Plan Options

Additional Resources

Healthcare News

Get the latest healthcare news!  Stay in the know!  Find out what's happening in congress and the latest regarding healthcare reform and the health insurance industry. 

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Summary of the ACA

The Affordable Care Act WILL cover all pre-existing conditions (anything you've been diagnosed with, treated for, taken medication for or had symptoms of within the last 24 months prior to the start of the policy).  The ACA also covers all preventative & wellness exams at 100%. This summary is a simple to understand guide of the new health insurance law.  

See Everything The ACA Has To Offer

Subsidy Calculator

The ACA might offer you subsidies where the government will pay a portion of your premium each month on your behalf.  The amount (if any) that you will receive depends on your total household income and number of household members.  Talk to a professional who can help you determine if you qualify and for how much.  The financial consequences of not claiming the correct income or household members could be devastating!  Click to see how much you qualify for.

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Quote & Apply

Click below to be taken to the my personal Health Insurance Marketplace where you can review plans and prices, pick and buy a plan and make your first payment!   Going this route, allows you to skip many of the steps that are required by the Federal or State Exchanges! 

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Insurance Library

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