What is the Marketplace and how might it affect you?
The Marketplace is where insurance companies provide health insurance quotes for people under age
65. Consumers can compare plan benefits and rates for a specific area (County, zip code and or state).
Policy contracts, benefits and provider networks for HMO and PPO plans can be confusing. A qualified
agent can help at no additional cost. Call us at (386) 252-5546.
The Affordable Care Act (ACA) requires a policy be issued without exclusions for preexisting conditions. Male and Female rates are the same. Policies must include
certain Essential Benefits. This includes maternity and newborn care, mental health, prescription
drug coverage, rehabilitative services, pediatric dental and vision. 2016 benefits require the annual
maximum out of pocket limit not to exceed $6,350.00. This maximum includes deductible, coinsurance and some
co-pays. Probably the most important benefit change is that your annual routine exams, also known as
preventive services will be fully covered. This includes lab and mammograms.
The word affordable often pertains to net premium. If you are not eligible for employer group benefits
including enrollment through a spouse's employer plan one might be eligible for a premium subsidy (tax
credit) that may be used to help pay your monthly premium. Follow this link to estimate your subsidy:
http://kff.org/interactive/subsidy-calculator/ enter in the information, if you qualify it will give an
approximate value of you subsidy.
Open Enrollment Period: November 1, 2015 through January 31, 2016.
Would you like a medical insurance quote? Call 386-252-5546
Enrolling in Healthcare for individuals and families after the open enrollment period ends on January 31, 2016
Typically the only way to enroll for 2016 after the open enrollment period
ends is by Special Enrollment Period.
Qualifying for the special enrollment period based on rules set by
the Affordable Care Act. Some examples are:
Next Open Enrollment Period will take place starting November 1 through December 15, 2015 For Jan. 1, 2016.
- Newly married
- Birth or adoption of a child will allow you to sign up for health coverage
- A change in workplace health insurance, such as loss of group coverage
- Moving to a new location: Coming from a different County, State or Country
- Having your current health plan involuntarily canceled (group or individual)
- A non-ACA individual medical policy at renewal
- A substantial reduction in earnings may also qualify a person or family
- Return from active Military duty
- Divorce or legal separation
- Death of a covered parent or spouse
- Loss of dependent status at age 26
We can help you obtain a Medical insurance (PPO, POS or HMO) plan through the
Marketplace. Using a qualified agent does not cost you additional premium. A
qualified agent can help explain available plans and the many differences in policies.
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