Get Covered with Health Insurance

On HealthCare.gov, which Florida and Texas use, Open Enrollment generally runs November 1 through January 15. Enroll by December 15 for coverage starting January 1; enrollments from December 16 through January 15 generally start February 1. Confirm the current dates at HealthCare.gov. Outside of Open Enrollment, you may qualify for a Special Enrollment Period if you experience certain life events like losing other coverage, getting married, having a baby, or moving to a new area.

Premium Tax Credits are generally available to households with income between 100% and 400% of the Federal Poverty Level (FPL). The enhanced credits that temporarily removed the 400% cap expired at the end of 2025, so the income limit applies again unless Congress changes the law. Cost Sharing Reductions (CSR) are available for incomes between 100% and 250% FPL with a Silver plan. Eligibility depends on household size, income and other factors; our licensed agents can help you check.

These 'metal tiers' indicate how you and your plan share costs. Bronze plans have the lowest monthly premiums but highest out of pocket costs when you need care (60/40 split). Silver plans are moderate (70/30 split) and are the only plans eligible for Cost Sharing Reductions. Gold plans have higher premiums but lower costs at the doctor (80/20 split). Platinum plans have the highest premiums but lowest out of pocket costs (90/10 split). All tiers cover the same essential benefits.

By law, all ACA Marketplace plans must cover: 1) Outpatient care, 2) Emergency services, 3) Hospitalization, 4) Maternity and newborn care, 5) Mental health and substance abuse services, 6) Prescription drugs, 7) Rehabilitative services, 8) Lab tests, 9) Preventive care and chronic disease management, and 10) Pediatric services including dental and vision for children. Preventive services like vaccines, screenings, and check-ups are covered at no cost to you.

It depends on the plan's provider network. Before enrolling, you should check if your preferred doctors, specialists, and hospitals are in the plan's network. Our agents help you verify provider participation before you enroll. Many plans offer broad networks, and you can also choose PPO plans that allow out of network care at a higher cost.

While the federal individual mandate penalty was reduced to $0 in 2019, some states (California, Massachusetts, New Jersey, Rhode Island, Vermont, and DC) have their own mandates with penalties for being uninsured. More importantly, being uninsured means you're responsible for 100% of medical costs, which can lead to significant debt from unexpected illness or injury. Having coverage protects both your health and finances.

As licensed health insurance agents, we provide personalized assistance throughout the enrollment process. We help you understand your options, compare plans from multiple insurers, check your eligibility for premium tax credits, and complete your application correctly. Insurance carriers pay our commission, so there is no extra cost to you, and you pay the same rates as going direct. We also provide year round support for questions about your coverage.

Obamacare (ACA Marketplace) plans are private health insurance for individuals and families who don't have coverage through an employer. You pay monthly premiums, though subsidies may reduce or eliminate this cost. Medicaid is a government program providing free or very low cost coverage to people with limited income. If your income is below 138% FPL in expansion states, you may qualify for Medicaid instead of Marketplace coverage. We can help determine which program is right for you.

Yes. The ACA Marketplace is designed for self employed individuals, freelancers, gig workers, and those between jobs. If you've lost employer coverage (COBRA is often expensive), you may qualify for a Special Enrollment Period. Self employed individuals can deduct their health insurance premiums as a business expense. Many self employed people qualify for significant subsidies based on their projected annual income.