Frequently Asked Questions
What’s changing with health insurance in 2025–2026?
The ACA Marketplace is updating subsidy eligibility, income thresholds, and plan networks. Many families who qualified for Medicaid during the pandemic are losing coverage under the Medicaid unwinding process. Premiums and deductibles are shifting, so even if you’re already insured, your plan may no longer be the best fit.
I review these changes for each client to make sure you keep the most affordable and effective coverage.
What is Medicaid unwinding and who is affected?
During the pandemic, Medicaid paused eligibility checks, so millions stayed covered. Now states are reviewing everyone’s eligibility. If your income is too high or your situation changed, you may lose Medicaid. Families with children, single adults, and seniors alike are being affected.
If you’ve received a letter, or if you’re unsure, I’ll help you quickly transition into a Marketplace plan so you don’t have a gap in coverage.
What happens if I miss Open Enrollment?
Open Enrollment for 2026 Marketplace plans runs November 1, 2025 – January 15, 2026. If you miss it, you cannot enroll in a Marketplace plan unless you qualify for a Special Enrollment Period. These are triggered by events like losing Medicaid, losing employer coverage, moving, getting married, or having a child.
I can check if you qualify and help you apply right away so you’re not left uninsured.
How do health insurance subsidies work in 2025?
Subsidies (also called “Advanced Premium Tax Credits”) reduce your monthly premium based on your household size and income. The thresholds were updated for 2025, meaning many people now qualify for larger discounts than before. Some plans are available for less than $10/month after subsidies.
I can run the numbers for you in minutes to see what financial help you qualify for.
Are ACA Marketplace plans really affordable?
Yes. Most people don’t realize how much the Marketplace reduces costs. In fact, over 80% of enrollees receive subsidies, and many end up paying less than $50/month — some under $10. The key is finding a plan that balances cost, coverage, and network.
I compare plans for you so you’re not overpaying or stuck with benefits you don’t need.
Can I keep my doctors and prescriptions?
Not all plans include the same doctors, hospitals, or prescription coverage. A plan might look cheap but not include your primary care doctor or medications. Marketplace plans are required to cover essential health benefits, but networks differ by insurer and region.
I always check your providers and prescriptions against the plan list so you can keep the care you trust.
What if I lose my job or current insurance?
Losing employer-sponsored insurance, Medicaid, or even private coverage qualifies you for a Special Enrollment Period. That means you can sign up for a Marketplace plan immediately, without waiting for Open Enrollment. Acting quickly is important — you usually have 60 days to enroll.
Contact me as soon as you lose coverage so we can set up a new plan before your old one ends.
What’s the difference between ACA Marketplace and private insurance?
ACA Marketplace: Subsidized, government-regulated, covers essential benefits, and guarantees no denial for pre-existing conditions.
Private “off-Marketplace”: May offer additional options or flexibility but no subsidies, so premiums are usually higher.
I’ll help you compare both so you know whether Marketplace or private coverage makes the most sense for your budget and needs.
How can I protect myself from scams and fraud?
Fraudulent calls, texts, and ads are increasing — especially ones promising “subsidy checks” or “extra benefits.” The Marketplace never calls asking for your Social Security number, bank info, or payment outside the official platform. Giving info to the wrong person can result in plan cancellations or even identity theft.
Always work with a licensed, verified agent (like me). I’ll handle your application safely and make sure your information is protected.
How do I get started today?
Getting covered is simple:
Call, text, or book an appointment with me.
I’ll review your income, household info, and providers.
Together, we’ll pick the best plan according to your needs — I’ll submit everything on your behalf and confirm your enrollment.
You don’t have to figure this out alone. I’ll guide you step by step and stay with you year-round.