Health Insurance

Our health insurance plans cover a wide range of healthcare services, including:

• Preventive care (annual check-ups, vaccinations, screenings)
• Doctor visits (primary care and specialists)
• Emergency and urgent care services
• Hospital stays and surgeries
• Prescription medications
• Laboratory tests and diagnostic imaging
• Mental health and substance abuse services
• Maternity and newborn care
• Pediatric services, including dental and vision care for children
• Rehabilitation services and devices

Coverage details vary by plan level (Bronze, Silver, Gold). For specific coverage information, please review the plan details or contact our customer service team.

Deductible: The amount you pay for covered healthcare services before your insurance starts to pay. For example, with a $2,000 deductible, you pay the first $2,000 of covered services yourself before insurance begins to share costs.

Copay: A fixed amount you pay for a covered healthcare service, usually when you receive the service. For example, you might pay $30 for a doctor's visit or $15 for a prescription. Copays don't usually count toward your deductible.

Coinsurance: The percentage of costs you pay for a covered healthcare service after you've paid your deductible. For example, if your plan's coinsurance is 20%, you pay 20% of the cost and your insurance pays 80%, after you've met your deductible.

Out-of-pocket maximum: The most you'll have to pay for covered services in a plan year. After you reach this amount, your insurance pays 100% for covered services.

Whether you can keep your current doctor depends on if they participate in our plan's network. We have an extensive network of healthcare providers, but it's always a good idea to check if your preferred doctors and hospitals are in-network before enrolling.

You can:

• Search our provider directory on our website
• Call our customer service team to verify if your doctor is in-network
• Ask your doctor's office if they accept our insurance plans

If your doctor is not in our network, you can still see them, but you may pay more out-of-pocket for their services. Some plans don't cover out-of-network care except in emergencies.

Premium subsidies (also called premium tax credits) are government financial assistance that reduces your monthly health insurance premium. They're available to eligible individuals and families with incomes between 100% and 400% of the Federal Poverty Level who purchase coverage through the Health Insurance Marketplace.

To qualify for subsidies, you typically need to:

• Have a household income between 100% and 400% of the Federal Poverty Level
• Not have access to affordable employer-sponsored coverage
• Not be eligible for government programs like Medicaid or Medicare
• File joint taxes if married
• Be a U.S. citizen or lawfully present immigrant

The amount of subsidy you receive depends on your income and the cost of benchmark plans in your area. Our quote tool provides an estimate of potential subsidies based on the information you provide.

You can typically enroll in a health insurance plan during:

• Open Enrollment Period: Usually runs from November 1 to December 15 each year for coverage starting January 1. This is the standard time when anyone can enroll in or change health insurance plans.
• Special Enrollment Period: If you experience certain life events (called qualifying life events), you may be eligible for a Special Enrollment Period. This allows you to enroll in or change your health insurance outside the annual Open Enrollment Period.

Qualifying life events include:

• Loss of health coverage (e.g., losing job-based coverage)
• Changes in household (e.g., marriage, birth, adoption)
• Changes in residence (e.g., moving to a new ZIP code)
• Other qualifying events (e.g., income changes affecting subsidy eligibility)

Special Enrollment Periods typically last 60 days from the date of the qualifying event.