Answers You Can Trust

Frequently Asked Questions About Health Insurance

We know health insurance can feel complicated, and it’s natural to have questions. That’s why we’ve gathered the most common ones we hear from our clients about Medicare, ACA Marketplace coverage, and group health insurance. These quick answers will give you clarity and confidence — and if you need more details, we’re always here to help.

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1. What is the difference between Medicare Advantage, Medigap, and Original Medicare?

Original Medicare (Parts A & B) is offered by the federal government, while Medicare Advantage (Part C) is offered by private insurers and often includes extra benefits. Medigap (supplemental insurance) helps pay the out-of-pocket costs that Original Medicare doesn’t cover.

2. When can I enroll in Medicare or change my plan?

Most people enroll at age 65 during their Initial Enrollment Period. You can also make changes each year during the Annual Enrollment Period (Oct. 15 – Dec. 7), or during certain Special Enrollment Periods if you qualify.

3. How do ACA subsidies work, and how do I know if I qualify?

ACA subsidies (premium tax credits and cost-sharing reductions) are based on your household income and family size. If you qualify, they can lower your monthly premiums and out-of-pocket costs. We’ll check your eligibility and help you apply.

4. What’s the difference between Marketplace (on-exchange) and off-exchange health insurance plans?

Marketplace (on-exchange) plans are available through Healthcare.gov or your state exchange and may qualify for subsidies. Off-exchange plans are sold directly by insurance companies and may be better for those who don’t qualify for subsidies.

5. Can I change my health insurance outside of Open Enrollment?

Yes, but only if you qualify for a Special Enrollment Period (SEP) due to a life event such as losing coverage, getting married, moving, or having a baby.

6. What is a Special Enrollment Period (SEP), and do I qualify for one?

A SEP is a time outside of Open Enrollment when you can sign up for health insurance due to a qualifying event. We can review your situation to see if you’re eligible.

7. Do you charge fees for helping me with my health insurance?

No — our services are completely free to you. We’re licensed insurance agents, and we’re paid by the insurance carriers when you enroll, not by you.

8. How do group health insurance plans work for small businesses?

Group health insurance allows employers to offer coverage to their employees, often with shared costs between the employer and employees. We’ll help you compare carriers, plan types, and contribution strategies to fit your business.

9. What documents or information do I need to get started?

Typically, we’ll need basic information such as your date of birth, address, household income, and a list of your current doctors and prescriptions. For group coverage, business details and employee census data are needed.

10. What ongoing support do I receive after I enroll?

Our relationship doesn’t end at enrollment. We’ll be here year-round to answer questions, help with claims issues, review your coverage during renewal periods, and make sure your plan continues to meet your needs.

Protect Your Health, Secure Your Future

That's exactly what we help you achieve. We provide personalized Medicare and health insurance solutions tailored to your unique needs, ensuring peace of mind and financial protection. Our expert team will guide you to the coverage that's right for you.

We're committed to providing reliable health insurance that ensures peace of mind for you and your loved ones. With a focus on comprehensive coverage and exceptional customer support, we're here to protect what matters most.

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