Individual Health Insurance
Who is eligible for health insurance?
This is an easy one – the answer is everyone! However, every person has their own, very individual case and health insurance has a lot of regulations. More information about the eligibility for any individual health insurance coverage can be received by calling our office or emailing us with your request.
When can health insurance be purchased?
Everyone can purchase coverage during Open Enrollment (see further information below on this page). There are some exceptions that allow people to have the option to purchase coverage mid-year.
In the middle of the year, health insurance can only be purchased in special occasions and no more than 60 days after the event, for example*:
1. Change of immigration status (obtaining a green card, work permit, other);
2. Moving from another country or state (if you have moved from another state, proof that you have had health insurance is required, as well as other requirements.)
3. Marriage (if one of the newlyweds previously had health insurance. There are additional conditions);
4. After a baby is born or after the adoption (there are various conditions.);
5. Losing your workplace health insurance.
6. Losing Medicaid insurance.
Individual health insurance usually does not cover medical expenses while on vacation, this is why you need travel insurance! Click below and learn more.
If you do not qualify for purchasing health insurance in the middle of the year and need coverage for a short time, you can purchase short – term insurance! Click below and learn more.
Open Enrollment
Do you not have health insurance and realize that it’s time for a change? Open Enrollment is the perfect time to purchase health insurance!
Health plan reviews and changes for the upcoming year begin on November 1st and end on January 15th. Our agency wants to provide our clients with the best customer service, and since Open Enrollment is a very busy season, we want to check your family information in advance, and make any necessary changes. Your cooperation can help prevent unnecessary errors/delays from happening!
What is important to know?
Think about what plan and insurance company you would prefer (you can learn more about main plan types below on this page).
It is your responsibility to make sure that your doctor is in your insurance plan network. Doctors and medical offices can stop taking certain insurance plans, which usually you cannot change.
We encourage all potential customers to fill out the application below on this page;
All existing customers who have had a change in their lives, please also remember to inform us ASAP by filling out the form below for existing customers.
What are the main types of plans?
HMO
Must select a PCP and/or medical group;
Must get a referral to see a specialist;
Must stay in the network.
PPO
Don‘t need to select a PCP and/or medical group;
No referral is necessary;
Not required to stay in the network, but there will be higher charges.
EPO*
(not in all states)
Don‘t need to select a PCP and/or medical group;
No referral is necessary;
Must stay in the network.
EXISTING CUSTOMERS, IF ANY
CHANGES HAVE OCCURED
POTENTIAL CUSTOMERS