Health insurance questions, answered

The common ones are losing other coverage (job coverage, Medicaid, or COBRA running out), moving to a new area, getting married, and having or adopting a baby. You usually have 60 days from the event to pick a plan. Dropping COBRA on purpose or not paying it doesn't count.

For 2027, if you enroll between December 16 and January 15, coverage starts February 1. To start on January 1, enroll by December 15.

Yes. Medicaid and KidCare take applications any time of year. Children under 19 can apply through Florida KidCare, and adults can check Medicaid at ACCESS Florida.

The deductible is what you pay for covered care before the plan starts paying its share. The out-of-pocket maximum is the most you pay in a plan year for covered in-network care, counting the deductible, copays and coinsurance. After you reach it, the plan pays the rest. Your monthly premium doesn't count toward either.

It is the second lowest cost Silver plan available where you live. Your tax credit is figured from its price: the IRS sets the share of income you are expected to pay, and the credit covers the rest of the benchmark price.

You might. The credit you get each month is based on your income estimate, and your real credit is settled on your tax return with Form 8962. If you earned more than you estimated, you may repay some or all of the difference, so report income changes to the Marketplace during the year.

No. ACA plans don't use health questions, and they can't turn you down or charge you more because of a pre-existing condition. Your price depends on age, ZIP code, tobacco use and the plan you pick.

Preventive care such as yearly checkups, many screenings and recommended vaccines costs nothing when you use an in-network provider, even before you meet the deductible. Care to diagnose or treat a problem is billed under the plan's normal costs.

Yes. Mental health and substance use services are essential health benefits, so every ACA plan covers them. Copays and networks vary by plan. HPG fixed indemnity does not cover counseling visits the way ACA plans must.

It means the plan pays a fixed cash amount for each covered service, no matter what the provider bills. On HPG Select 2000, for example, a doctor visit pays $80. If the bill is higher, you pay the rest, and there is no out-of-pocket maximum to stop it.

HPG uses the UnitedHealthcare Choice Plus network. Check the plan brochure for how seeing a provider in or out of that network affects you. HPG also includes HealthiestYou by Teladoc Health for virtual visits and an Optum Perks prescription discount card.

Some do. Each plan has yearly limits on doctor visits and prescription fills, and several of those limits, along with the daily hospital benefit, increase starting in the second calendar year. The brochure lists the exact amounts.

No. Enter your ZIP code, date of birth, sex, tobacco use, household size and income on the quote form and the prices appear. You don't need an account either.

You finish the Marketplace application on HealthSherpa, a private enrollment site connected to the federal Marketplace. Licensed agents can help with the application for free.

HPG prices depend on age, sex and tobacco use, and women pay more than men at most ages in our quotes. ACA prices can't vary by sex, but they can depend on tobacco use, so we ask once and use the answers for both.