Frequently Asked Questions

Yes, children may qualify for Medicaid or the Children’s Health Insurance Program (CHIP), even if you don’t qualify for Medicaid. CHIP provides comprehensive coverage for doctor visits, prescriptions, vaccines, and more.

Yes! Children under 26 can remain on their parents’ health insurance plan, regardless of whether they live at home, are married, or are in school.

‍

Yes! Most ACA Marketplace plans allow families to enroll together under one policy. You can customize coverage to meet your family’s unique needs, including maternity care, pediatric services, and preventive healthcare for everyone.

‍

When selecting a plan, you can check if your family’s doctors are in-network. Many ACA plans offer broad networks of trusted providers to ensure you don’t need to switch.

Yes! All ACA Marketplace plans include maternity care, newborn care, and pediatric services, such as:

• Vaccines
• Annual wellness checkups
• Vision and dental care for children

Subsidy eligibility is based on household size and income. For example, a family of four with an income between $30,000 and $120,000 may qualify for financial assistance. Contact us for personalized help.

The application process typically takes about 10–15 minutes. You can apply online, over the phone, or with help from one of our licensed agents.

Once enrolled, you’ll pay your monthly premiums directly to the insurance company. Your family’s coverage will begin on January 1 if you enroll by December 15 or February 1 if you enroll by January 15.

Many families qualify for financial assistance through the ACA, including:

• Premium Tax Credits: Reduce your monthly premiums.
• Cost-Sharing Reductions: Lower out-of-pocket expenses like deductibles and copayments.
• Medicaid and CHIP: These programs provide free or low-cost coverage for eligible families and children.

If you experience a qualifying life event, such as:

• Having a baby
• Getting married or divorced
• Relocating to a new area‍

You may qualify for a Special Enrollment Period (SEP) to adjust or start coverage outside the Open Enrollment window.

‍

While we don’t handle Medicaid or CHIP enrollment, you can apply for these programs through HealthCare.gov or your state’s Medicaid office.

We can help! Subsidies are based on your household size, income, and location. Contact us for personalized assistance in determining your eligibility.

Choosing the Right Health Insurance Plan

Selecting a health insurance plan can be overwhelming due to the variety of options available. Here are some key factors to consider:

1. Assess Your Healthcare Needs: Consider your medical history, frequency of doctor visits, and any ongoing treatments.
2. Compare Costs: Look at premiums, deductibles, copayments, and out-of-pocket maximums to understand the total cost of each plan.
3. Check Provider Networks: Ensure your preferred doctors and hospitals are included in the plan's network.
4. Review Coverage Options: Make sure the plan covers the services you need, such as prescription drugs, mental health services, and preventive care.

Taking the time to evaluate these factors can help you make an informed decision about your health insurance coverage.

Types of Health Insurance Plans

There are several types of health insurance plans available, each with its own features and benefits. The most common types include:

• Health Maintenance Organization (HMO): Requires members to choose a primary care physician and get referrals for specialists.
• Preferred Provider Organization (PPO): Offers more flexibility in choosing healthcare providers and does not require referrals.
• Exclusive Provider Organization (EPO): Similar to PPOs but does not cover any out-of-network care except in emergencies.
• Point of Service (POS): Combines features of HMO and PPO plans, allowing members to choose between in-network and out-of-network providers.

Choosing the right type of health insurance depends on your healthcare needs and financial situation.

After January 15, you or your family can only enroll in a health plan if you qualify for a Special Enrollment Period or are eligible for Medicaid or CHIP, which offer year-round enrollment.

If you’re already enrolled through HealthCare.gov, you’ll need to update your details directly on their website or by contacting their support team at 1-800-318-2596.

Choosing the Right Health Insurance Plan

Selecting a health insurance plan can be overwhelming due to the variety of options available. Here are some key factors to consider:

1. Assess Your Healthcare Needs: Consider your medical history, frequency of doctor visits, and any ongoing treatments.
2. Compare Costs: Look at premiums, deductibles, copayments, and out-of-pocket maximums to understand the total cost of each plan.
3. Check Provider Networks: Ensure your preferred doctors and hospitals are included in the plan's network.
4. Review Coverage Options: Make sure the plan covers the services you need, such as prescription drugs, mental health services, and preventive care.

Taking the time to evaluate these factors can help you make an informed decision about your health insurance coverage.

Understanding Health Insurance

Health insurance is a type of insurance coverage that pays for medical and surgical expenses incurred by the insured. It can also provide coverage for other types of health-related expenses, such as preventive care, prescription drugs, and mental health services. The primary purpose of health insurance is to protect individuals from high medical costs and to ensure access to necessary healthcare services.

How Does It Work?

When you have health insurance, you pay a premium, which is a monthly fee, to maintain your coverage. In return, the insurance company agrees to cover a portion of your medical expenses. Depending on your plan, you may also have to pay deductibles, copayments, and coinsurance. Understanding these terms is crucial for managing your healthcare costs effectively.

Preventive healthcare includes free services like routine checkups, vaccinations, and screenings. These services are covered at no cost under most Marketplace plans, helping you stay healthy and catch potential issues early.

The ACA open enrollment period typically runs from November 1 to January 15, but you may qualify for a Special Enrollment Period if you’ve experienced a qualifying life event like marriage, divorce, relocation, or job loss.

The Importance of Health Insurance

Health insurance is essential for several reasons. Firstly, it provides financial protection against unexpected medical expenses, which can be overwhelming without coverage. Secondly, having health insurance increases your access to healthcare services, allowing you to seek medical attention when needed without the fear of incurring high costs. Lastly, many employers offer health insurance as part of their benefits package, making it a valuable asset for employees.

Preventive Care

Health insurance often covers preventive services, such as vaccinations and screenings, at no additional cost. This encourages individuals to seek regular check-ups and maintain their health, ultimately leading to better health outcomes.

Yes! We specialize in helping families and individuals enroll in ACA (Affordable Care Act) health plans. We’ll guide you through the process and ensure you get the right plan for your needs.

Yes! Most ACA Marketplace plans allow families to enroll together under one policy. You can customize coverage to meet your family’s unique needs, including maternity care, pediatric services, and preventive healthcare for everyone.

‍

Yes! The ACA makes sure that all Marketplace plans cover pre-existing conditions without charging higher
premiums or denying coverage.

• Conditions like diabetes, asthma, cancer, and pregnancy are fully covered.
• You can't be denied coverage or charged more based on your health history.

You can find your Form 1095-A on your HealthCare.gov account under the 'Tax Forms' section. If you need further assistance, contact the HealthCare.gov support center at 1-800-318-2596.

After January 15, you or your family can only enroll in a health plan if you qualify for a Special Enrollment Period or are eligible for Medicaid or CHIP, which offer year-round enrollment.

If you’re already enrolled through HealthCare.gov, you’ll need to update your details directly on their website or by contacting their support team at 1-800-318-2596.

The ACA open enrollment period typically runs from November 1 to January 15, but you may qualify for a Special Enrollment Period if you’ve experienced a qualifying life event like marriage, divorce, relocation, or job loss.

Preventive services covered by ACA plans include:

• Vaccinations (e.g., flu shots)
• Blood pressure, diabetes, and cholesterol screenings
• Cancer screenings like mammograms and colonoscopies
• Counseling to quit smoking and for weight management
• Routine checkups for adults, women, and children

‍

No, Wise Health Choices is not HealthCare.gov. We are a private company offering personalized assistance to help you navigate ACA health plans, including those available on the HealthCare.gov marketplace.

We may have reached out because you expressed interest in health insurance options. If you’re looking for personalized help, we’re here to guide you! If you were looking for HealthCare.gov, their support number is 1-800-318-2596.

No, we cannot assist with account management for HealthCare.gov. You can reset your password by visiting HealthCare.gov or calling their support line at 1-800-318-2596.

No, Wise Health Choices is not HealthCare.gov. We are a private company offering personalized assistance to help you navigate ACA health plans, including those available on the HealthCare.gov marketplace.

The official HealthCare.gov support center can be reached at 1-800-318-2596 for questions about your account, tax forms, or coverage.