You went to sign up and learned you do not qualify for help with the monthly bill. Or you did last year, and this year the number on the screen is the whole price. That feels like a bill for something you did not order. Before you accept it, there are a few things to check, and a few options to put side by side. This page explains them honestly, including the ones that are not us. Prime Health Consultants is an independent insurance agency in Sunrise, Florida. Our licensed advisors explain private health plans in plain language, in English or Spanish.
Help with monthly costs on the Marketplace is tied to your household size, your estimated income and other rules, including whether a job offers you coverage. Those rules change over time. Someone who qualified in one year may not in another, even if nothing at home changed.
We do not decide this. HealthCare.gov does, based on your application. That is also why it is worth looking again.
Look at the income you reported. If your income is uneven, such as freelance or commission pay, an estimate made months ago can be off. Update the application if your household or income has changed, and see what the site says now. You may find you qualify. You may find you do not. Either way you will know.
Do not guess and do not skip this step. It is the one that can change everything below.
Marketplace plans come in levels, often called bronze, silver, gold and platinum. In general, a plan with a smaller monthly payment asks for more when you use care, and the reverse is also true. Choose the level that matches how much care your family uses and how much you could handle in a hard year. Some plans may be used with an HSA, an account set aside for health costs. Our blog explains how that differs from an FSA.
We do not sell Marketplace plans, so a conversation with HealthCare.gov comes first.
A private plan is another option to compare. It is not a Marketplace plan and does not qualify for premium tax credits. You can apply any time of year. The plans we offer are private plans, not ACA Marketplace plans, and they have exclusions and limitations. An advisor explains the details.
A private plan is not the right fit for everyone. Our plans are for people under 65.
Use the same list for every option. What is the monthly payment? What is the deductible? What is the out-of-pocket maximum? Are my doctors in the network? Are my medications covered? What does the plan exclude? When would it begin? Write each answer down. Side by side, the right choice is often easier to see.
If you want to see what help with monthly costs your household qualifies for, start with the Marketplace. If you want to compare a plan that can be applied for at any time, a private plan is worth a look. Your income may also change from one year to the next, so what is right now may not be right next year.
Prime Health Consultants is not affiliated with HealthCare.gov or any government agency. The private plans we offer are not Marketplace plans and don't qualify for premium tax credits. To see Marketplace plans and any savings you qualify for, visit HealthCare.gov.
Recheck your application. Update your income and household on HealthCare.gov and see what it says now.
Talk with a licensed advisor. We explain private plans and tell you plainly when the Marketplace may be the better route.
Compare side by side, then apply. Keep your current plan until a new one is active.
Prime Health Consultants
1550 Sawgrass Corporate Pkwy, 3rd Floor, Sunrise, FL 33323Phone: (305) 333-1434 · WhatsApp: (786) 675-7004
Hours: Mon–Fri 9 AM–9 PM · Sat 9 AM–8 PM · Sun 9 AM–5 PM
Get directionsAreas we serve: All of Florida, by phone, WhatsApp or video, and in person at our Sunrise office. Our licensed agent Julio Fernandez is licensed in 30 states.
Help is based on household size, estimated income and other rules, such as whether a job offers coverage. These can change from year to year. HealthCare.gov decides, and you can update your application at any time to see where you stand.
Yes. You can update your income and household information on HealthCare.gov and see the new result. Keep your documents in case the site asks for proof.
No. Premium tax credits come only through the Marketplace. A private plan is a different kind of plan with different rules.
No. Premium tax credits come only through the Marketplace, and private plans do not qualify for them. Start at HealthCare.gov to see what your household qualifies for.
It can be, if you rarely use care and can handle a large bill in a bad year. It can be a poor fit if you see doctors often. Ask your advisor to walk through both cases.
No. We are glad to compare your options with you, and the decision stays with you.
No. We work with plans for people under 65 and we do not offer Medicare. For Medicare questions, contact Medicare at 1-800-633-4227 or Florida SHINE at 1-800-963-5337.