- Do I qualify for a subsidy?
- Households between roughly 100% and 400% of the federal poverty level qualify for premium tax credits under current rules, and expanded subsidies above that range come and go as Congress revises the rules. We'll run the numbers based on estimated income and household size, using the rules in force when we quote — there's no obligation either way.
- Can I keep my doctor on a new plan?
- Sometimes. Each plan has a specific network — even within the same carrier, different plans cover different doctors and hospitals. Before you enroll we'll check your providers against the network so there are no surprises in January.
- What if I miss open enrollment?
- You'd need a qualifying life event (loss of other coverage, marriage, divorce, new baby, move to a new area, certain income changes) to enroll outside open enrollment. Short-term plans are an option in some cases but cover much less. We'll walk through what fits your situation.
- When exactly is the Florida open-enrollment window?
- November 1 through December 15 each year for coverage effective January 1. (CMS shortened the federal open-enrollment window to December 15 starting with the 2027 plan year — it previously ran to January 15.) After December 15, you generally need a qualifying life event to enroll. Florida runs on the federal Healthcare.gov platform, so dates match the federal calendar. We watch the dates and reach out to clients ahead of the deadline.
- What counts as a special enrollment triggering event?
- Loss of other coverage (job termination, COBRA expiration, aging off a parent's plan at 26), marriage, divorce, birth or adoption of a child, moving to a new ZIP code or county, becoming a U.S. citizen, leaving incarceration, and certain income changes that make you newly subsidy-eligible. You have 60 days from the event to enroll, and most events require documentation. Some events (job loss documentation, marriage certificate, birth certificate, lease showing move) need to be uploaded during the application.
- How does the subsidy income threshold actually work?
- Premium tax credits scale on a sliding curve from roughly 100% to 400% of federal poverty level under standard rules, measured against the prior year's federal poverty guidelines (the dollar brackets are updated every year and depend on household size). The thresholds move annually and Congress revises subsidy rules often — including whether subsidies extend above the 400% cap — so we confirm eligibility against the current figures. The subsidy is calculated based on estimated annual income — overestimate and you get less; underestimate and you may owe back at tax time. We help calibrate the income estimate at enrollment.
- Off-exchange vs on-exchange — what's the difference?
- On-exchange (Healthcare.gov) plans qualify for premium tax credits and cost-sharing reductions. Off-exchange plans are sold directly by the carrier and don't qualify for subsidies — but they sometimes offer broader networks, lower deductibles, or plans not on the marketplace. If your household income is above subsidy range, off-exchange may give better value. Below subsidy range, on-exchange almost always wins. We quote both when it matters.
- Can I add dental and vision to my health plan?
- Sometimes bundled, often separate. Most ACA medical plans don't include adult dental or vision (pediatric dental and vision are required as essential health benefits for kids under 19). Standalone dental plans run $25-$60/month for individuals; vision plans run $10-$25/month. Some carriers bundle dental and vision into the medical plan as a package — we'll show you both options. The decision often comes down to whether you'll actually use the coverage (annual exams, prescription glasses) vs paying out of pocket.
