Individual Health Insurance FAQs

Can I purchase an individual health insurance plan with an agent at any time throughout the year?

For most residents, the Open Enrollment period for buying health insurance closes on December 15 each year, depending on the state. However, if you have a qualifying life event, you are eligible for a “Special Enrollment Period” (SEP). During this 60-day period, you may purchase individual health insurance coverage, even if it is outside of Open Enrollment.

What qualifies as a SEP (Special Enrollment Period)?

The following are examples of situations that would qualify you for a Special Enrollment Period:

-Termination of job-based, employer-sponsored, or COBRA coverage

-Loss of individual health insurance coverage for a plan you bought yourself

-Expired insurance coverage through a family member

-End of eligibility for Medicaid, Children’s Health Insurance Program (CHIP), or Medicare Advantage Plans

-Changes in household size due to marriage, birth, divorce, or death

-Moving to a new home in a new zip code or county

-Other circumstances outlined at Healthcare.gov

Contact Rejoyce today for more details. As an independent insurance agency, our assistance is available at no extra cost to you, whether you are trying to get a quote from insurance providers as a self-employed individual or want to be sure you have the best individual insurance, group health insurance, or other insurance policies from the best insurance providers.

I do qualify for a SEP. What is the Marketplace and why should I purchase health insurance there?

The health insurance Marketplace is a health insurance exchange – an online collective where individuals, families, and small businesses can purchase group or personal health insurance. Plans on the exchange are offered in three different coverage levels: gold, silver, and bronze. Each insurance plan is required to cover 10 essential health benefits. If you purchase your plan through the Marketplace, you may be eligible to receive a government subsidy to assist in paying for your health insurance premiums.Rejoyce can help you navigate the Health Insurance Marketplace at no additional cost to you. Contact us today for more information and details about our no-cost assistance.

Will I qualify for a subsidy to help with my individual health insurance premiums?

Many people qualify for cost-saving subsidies but don’t realize they can combat high insurance premiums and reduce insurance costs. Subsidy tax credits are available for individuals earning between $12,140 and $48,560. The income limits change based on household size. For instance, a family of four can earn up to $100,400 and still qualify for a subsidy. Don’t miss out on a subsidy you deserve.Consult with one of our licensed health insurance agents to see if you qualify for financial assistance to lower your monthly premiums. We specialize in finding quality health insurance at affordable prices across a wide array of insurance companies.

If I won’t qualify for a subsidy, do I still need to purchase my plan from the Marketplace?

If you know your income is too high to qualify for a subsidy, you can purchase your medical plan directly from the insurer and take advantage of working with a no-cost health insurance agent. Keep in mind you will still need a Special Enrollment Period to be able to enroll in any health plans among your available individual or family health insurance options.

What are the “Essential Health Benefits?”

Essential health benefits are specific services that, according to the Affordable Care Act, must be included in any health plan sold to individuals or businesses to be considered compliant. These benefits include coverage for events like maternity, newborn care, hospitalization, ambulatory care, and prescription drugs.

Do I need to carry health insurance?

As of 2019, there is no longer a federal tax penalty if you do not have individual health insurance. However, some tax penalties may be enforced on the state level, which individuals will see on their taxes. Even if your state does not enforce tax penalties, you still run the risk of exorbitant hospital bills should you have a major medical incident. We highly recommend speaking with a licensed health insurance agent at Rejoyce. More options are becoming available, and we can help you find the right plan for the right price.

How can a health insurance broker help me?

Although the Marketplace has navigators to help customers apply for government subsidies, a health insurance broker can do this as well and make the health insurance enrollment process even easier at no additional cost to you. Health insurance brokers can recommend a health insurance plan based on your budget, help you understand your benefits, and support you even after enrollment. Health insurance agents with Rejoyce hold a state license, undergo criminal background checks, and use their insurance expertise to find you the best coverage.