Frequently Asked Questions
Navigating the Insurance Marketplace can be difficult and sometimes overwhelming. Below, in our frequently-asked-questions, you’ll find information to help choose the right plan. Of course, our staff is ready to assist you – call or walk into our local office and speak to your health care advocate anytime.
What are Essential Benefits?
- Ambulatory Patient Services
- Mental Health & Substance Use Disorder Services, Including Behavioral Health Treatment
- Rehabilitative & Habilitative Services & Devices
- Laboratory Services
- Emergency Services
- Maternity & Newborn Care
- Prescription Drugs
- Preventative Wellness Services & Chronic Disease Management
- Pediatric Services (pediatric oral care may be included or offered as part of a stand-alone dental plan)
When is open enrollment?
When will my coverage begin?
Who can use the Marketplace?
- Must live in the United States.
- Must be a U.S. citizen or national (or be lawfully present). Learn about eligible immigration statuses.
- Can’t be incarcerated.
If you have Medicare coverage, you’re not eligible to use the Marketplace to buy a health or dental plan. Learn more about Medicare and the Marketplace.
Can I get coverage outside of the open enrollment period?
- The Special Enrollment Period: You can qualify if you lose job-based coverage, have a baby, get married, or have certain other life changes.
- Medicaid or the Children’s Health Insurance Program (CHIP): You can apply any time and can enroll immediately if you’re eligible.
- Short-term Major Medical Health Insurance Plans with coverage duration periods of 30 days to 3 years.
SPECIAL ENROLLMENT EXCEPTIONS
Special Enrollment Period (SEP) is a time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain life events, including:
LOSS OF HEALTH COVERAGE
HAVING A BABY
ADOPTING A BABY
If you qualify for an SEP, you usually have up to 60 days following the event to enroll in a plan. If you miss that window, you have to wait until the next Open Enrollment Period to apply. For more information and specifics and to see if you qualify for a Special Enrollment Period, click on the link below.
Call toll free: 866.454.4458
Rather talk in person? Call or stop into our office. We’re here to help.