ACA Marketplace Plans
Find affordable coverage with potential income-based savings. We help you compare plans and enroll with confidence.
What to know
- Metal tiers: Bronze, Silver, Gold, Platinum—balance premium vs. out-of-pocket.
- Networks: HMO, EPO, PPO—check your doctors and hospitals.
- Costs: Deductible, copays, coinsurance, and the out-of-pocket maximum.
- Savings: APTC premium tax credits and CSR cost-sharing reductions may lower your costs based on household size and income.
- Enroll windows: Open Enrollment (typically Nov–Jan) or year-round with a Qualifying Life Event.
Document Checklist
- Names, DOBs, and SSNs for applicants
- Home address and contact info
- Estimated yearly household income
- Employer and current coverage details (if any)
- Preferred doctors and prescriptions
Private & Off-Exchange Plans
When Marketplace coverage isn’t the best fit, private plans may help bridge a gap or target specific needs. We’ll compare options and explain tradeoffs plainly.
When private plans make sense
- Timing: Need coverage before the next ACA window.
- Underwriting: Some plans review medical history and can decline or exclude conditions.
- Networks: Often PPO-style with broader access; verify providers.
- Compliance: Private options do not offer ACA subsidies—if you qualify for APTC/CSR, Marketplace plans usually cost less.
*First Health Nationwide PPO Network Owned by Aetna
*$0 Deductible - First Dollar Coverage – No Calendar Year Deductible to Satisfy for
ANY CLAIM.
*$0 Co-Pay - $0 Co-Insurance
*22 Doctor Visits per person per calendar year that include: Chiropractor,
Acupuncture, ALL Specialists, Counseling, PCP, Testosterone & Hormone
Replacement Therapy, Massage Therapy (treatment) – ANY Licensed Provider!
*UNLIMITED 24/7 TeleHealth Virtual Doctor Visits at NO CHARGE
*Guaranteed Renewable - Permanent Insurance to age 65
*You can never be singled out for a rate increase!
*You can NEVER be Canceled (Only for non-payment of premiums)
*NO Daily Hospital Confinement Cap/Max – Unlimited Hospital Confinement
*Daily Prescription Benefit
*$5,000,000 Policy Maximum
*Major Illness Lump Sum Check: $10,000-$50,000 Paid to YOU for your personal bills etc
Example Monthly Rates Male/Female (Non-Smoker):
18 year old: M:$138 F:$148 45 year old: M:$230 F:$242
25 year old: M:$138 F:$148 50 year old: M:$284 F:$286
30 year old: M:$150 F:$161 55 year old: M:$342 F:$327
35 year old: M:$162 F:$173 60 year old: M:$449 F:$411
40 year old: M:$194 F:$204 64 year old: M:$524 F:$466
Careington PPO Dental
add $23.20/Month
Dental, Vision & Hearing
Add affordable dental, vision, and hearing benefits for routine care and big-ticket items. We’ll review waiting periods and provider networks so there are no surprises.
Highlights
- Preventive dental often covered at 100% in-network.
- Basic/major services may have waiting periods—ask about no-wait options.
- Orthodontic and implants available on select plans.
- Vision: exams, frames, lenses, and contacts with large retail networks.
- Hearing aid benefits and discounts available on many carriers.
Small Business & Groups
Offer benefits that attract and retain talent. We guide small employers through setup, contributions, and ongoing support.
How group coverage works
- Plan types: Traditional small-group, level-funded/partially self-funded options.
- Employer setup: Basic company info, payroll, and employee census.
- Participation & contributions: Typical rules apply; we’ll outline options.
- Stipends/HRAs: QSEHRA/ICHRA concepts can pair reimbursements with individual plans.
- Our support: Quoting, onboarding, renewals, and employee education.
Group Quote Checklist
- Employee census (names, DOBs, ZIPs)
- Business name and address
- Industry and employee count
- Desired employer contribution
- Current plan details (if any)
FAQs
Quick answers to common questions. For personalized advice, reach out—we’re here to help.
You may qualify for a Special Enrollment Period after events like moving, losing other coverage, marriage, or having a baby. Most SEPs require documentation and have deadlines.
Based on your estimated annual household income and size, APTC lowers premiums and CSR reduces out-of-pocket costs on Silver plans. We’ll help check eligibility and estimate savings.
HMO generally requires referrals and in-network care; EPO typically doesn’t cover out-of-network except emergencies; PPO offers some out-of-network coverage at higher cost.
You’ll usually pay more or all costs out of network. We can search plans with your preferred providers to minimize surprises.
Only with a qualifying life event or during Open Enrollment. Some private plans may allow monthly starts, subject to underwriting.
Many private options are not ACA-compliant and may exclude pre-existing conditions or essential health benefits. They also do not include federal subsidies.
Often yes—many standalone dental and vision plans allow year-round enrollment. Waiting periods may apply for major services.
Yes. If you’re approaching 65, review Medicare timelines to avoid penalties and gaps. We can help you compare Medicare with ACA options.