What are the Open Enrollment Dates for 2017?

Nov 1, 2016 to Jan 31, 2017

Nov 1, 2016 – Enrollment begins for a Jan 1, 2017 effective date
Dec 15, 2016 – Final day for a Jan 1, 2017 effective date
Jan 15, 2017 – Final day for a Feb 1, 2017 effective date
Jan 31, 2017 – Final day for a Mar 1, 2017 effective date
Jan 31, 2017 – Last day of the open enrollment period

After open enrollment ends on Jan 31, 2017 you won't be able to get health coverage through the Marketplace until the next annual enrollment period, unless you have a qualifying life event. It's important to remember if you don't buy health insurance coverage you will be responsible for 100% of the cost of your medical care.

What is the difference between ON and Off Marketplace plans?

Basically, the plans offered ON and OFF Marketplace have the SAME qualified health plan benefits and premiums. If you are NOT eligible for a Premium Tax Credit (subsidy), you can apply for Off Marketplace plans here. They may offer additional OFF Marketplace health plans. On Marketplace (public government-run marketplace) is where you would apply for financial help from the government. Apply for ON Marketplace plans here.

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When I apply for a Subsidy, how do I keep Susan Speciale as my insurance agent?
Apply here

If you qualify and apply to receive a Premium Tax Credit (subsidy), provide the following agent information on your application at Healthcare.gov:

Insurance Agent: Susan Speciale
National Produce Number (NPN): 1635661

What are PPO, HMO, EPO, and POS plans?

Most health insurance plans offered in the Marketplace have networks of hospitals, doctors, specialists, pharmacies, and other health care providers.

- Preferred Provider Organization (PPO): A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network. You can use doctors, hospitals, and providers outside of the network for an additional cost.
-Health Maintenance Organization (HMO): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage.

- Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you go to doctors, specialists, or hospitals in the plan’s network (except in an emergency).
- Point of Service (POS): A type of plan in which you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans also require you to get a referral from your primary care doctor in order to see a specialist.

Can anyone get health care coverage?

Insurance companies can no longer deny coverage because you have a medical condition, and you don’t have to pass a medical exam to qualify for coverage.

What is a “grandfathered” plan?

A health plan that has been in existence since on or before March 23, 2010, and that meets certain requirements. Grandfathered plans are exempt from some of the changes required under the Affordable Care Act.

If I change to a different insurance company, do I need to cancel my old policy?

Yes. Contact your current insurance company.

Do I have to take a physical to get health insurance?

No, plans are guaranteed issue.

Can I be turned down or pay more for a medical condition?

No, plans are guaranteed issue.

How are the rates determined for my insurance?

Premiums are calculated by these factors: location, age, family size, tobacco use, and plan category. Health status and gender don’t affect pricing.

Can I qualify to save on health insurance coverage?

Yes. After running a quote if your income reflects that you may qualify for a subsidy contact me.

If I received a Premium Tax Credit this year, do I need to update my information next year?

Yes, if your income will change next year.