Health Insurance

Get Expert Help Navigating Health Insurance Options

Searching for health insurance can be overwhelming. With so many options, terms, and networks, it can be difficult to know where to start. At First Integrity Insurance Solutions, we are here to guide you through the process and help you find the best health insurance plans that fit both your healthcare needs and budget. Our experts will work with you to ensure you select the right coverage, whether you are considering Marketplace plans or Off Marketplace health insurance options.

Individual and Family Health Insurance Options

Marketplace Health Insurance (ACA Plans)
Off Marketplace Health Insurance
Short Term Health Insurance

What is Marketplace Health Insurance?

Affordable Care Act/Obamacare plans

The Affordable Care Act (ACA), also known as Obamacare, was enacted in 2010 to provide more Americans with access to affordable health insurance coverage. This law assists individuals who fall between 100% to 400% of the federal poverty limit (FPL) with subsidies to help pay for the insurance premiums. For the 2023 plan year, 90% of Marketplace enrollees qualified for subsidies (APTC); 48% qualified for cost sharing reductions(CSR), making it more affordable than ever.

What Does Marketplace Health Insurance Cover?

Marketplace health insurance plans must cover a wide range of essential health benefits, as mandated by the Affordable Care Act (ACA). All marketplace plans must cover treatment for pre-existing conditions and do not result in increased premiums based on those conditions. No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started.

Preventive Care: This includes screenings, vaccinations, and counseling for conditions such as obesity, depression, and smoking cessation.
Emergency Services: Coverage for emergency room visits, including ambulance services.
Hospitalization: Treatment for illnesses and injuries requiring hospital stays, including surgeries and overnight stays.
Prescription Drugs: Many plans offer coverage for prescription medications, with varying copayments or coinsurance depending on the specific drugs and plan.
Maternity and Newborn Care: Prenatal care, childbirth, and care for newborns.
Mental Health and Substance Use Disorder Services: Coverage includes counseling, therapy, and treatment for mental health conditions and substance use disorders.
Pediatric Care: This includes well-child visits, immunizations, and dental and vision care for children.
Lab Tests and Diagnostic Services: Coverage for laboratory tests, such as blood tests and X-rays, as well as diagnostic services like MRIs and CT scans.
Rehabilitative and Habilitative Services: Coverage for services aimed at helping individuals recover from injuries or manage chronic conditions, as well as services to help individuals with disabilities learn new skills or adapt to daily life.
Ambulatory Care: Outpatient services, including doctor visits, specialist consultations, and outpatient surgeries.

Plans will vary based on your location. The carriers that we represent are; Blue Cross Blue Shield, United Healthcare, Aetna, Oscar, Baylor Scott & White, Cigna, Ambetter, Molina, Christus, and Ascension. Since not all plans are offered everywhere, it is best to work with a licensed independent insurance agent to help you find the plans that are offered in your area.

Who Can Qualify for ACA Marketplace Health Insurance?

To qualify for subsidized ACA health insurance, you must meet several criteria, including:

For individuals, if you are between the ages of 26-64, and you do not have access to affordable group health insurance through your employer.
You are a US citizen or you are lawfully present in the United States for the duration of the plan year.
Your income falls between 100% – 400% of the Federal Poverty Level based on your tax household and filing status. If you are married, you must file jointly.
You are self-employed and your MAGI falls between the 100% – 400% of the Federal Poverty Level.
If you are retired and do not have access for a job based health insurance plan.

When Can I enroll in an ACA Marketplace Plan?

The Open Enrollment Period is the main time to apply for Marketplace plans, which occurs November 1st to January 15th every year. However, you can enroll during Special Enrollment Periods (SEPs) if you’ve had a qualifying life event such as:

Marriage or divorce
Birth, adoption of a child, or placement for foster care
Loss of minimum essential coverage (MEC). This includes loss of job-based coverage, Medicaid, CHIP, COBRA in the last 60 days
Change in household size (e.g., gaining or losing a dependent)
Relocation to a new area that offers different Marketplace plans
Loss of eligibility for Medicare, Medicaid, or CHIP during the redetermination period
Certain changes in income that affect eligibility for premium tax credits or cost-sharing reductions
If your income falls between the 100% -150% of the FPL. (This is a temporary SEP and is subject to change.)
Released from incarceration
Gained a lawfully present immigration status or became a U.S. citizen.

If you experience a qualifying life event, you have a limited time window (usually around 60 days) to enroll in a new plan or make changes to your existing coverage through a special enrollment period (SEP). It’s essential to act promptly and provide documentation of the qualifying event when applying for coverage during an SEP. If you are unsure whether or not you may qualify for a special enrollment election period, call us to discuss you options. This is constantly changing, so it doesn’t hurt to check and see.

Why Choose First Integrity Insurance Solutions?

At First Integrity Insurance Solutions, we prioritize personalized service and ensure our clients get the coverage that best suits their needs. As an independent insurance broker, we with top-rated insurance providers including Blue Cross Blue Shield, United Healthcare, Aetna, Cigna, to help you find affordable, high-quality insurance options.

Work With A Trusted Health Insurance Expert

Having an independent insurance expert by your side can make all the difference. Our specialists will guide you through your options and heal you find the most suitable plan for you unique situation. Contact us today to get started, or enroll directly through our online enrollment link.

We also offer dental and vision insurance options as well, so don’t hesitate to ask about those benefits!