Question 1

I'm a green card holder — am I eligible for ACA?

Accepted Answer

Yes. Lawful permanent residents are eligible from day one and may qualify for premium tax credits based on income.

Question 2

How does enrollment work for a mixed-status household?

Accepted Answer

Eligible members can enroll without affecting ineligible members. Immigration information for ACA is not used for enforcement.

Question 3

Can my children qualify for CHIP even if I don't?

Accepted Answer

Often yes. 35+ states cover lawfully residing immigrant children under CHIP without the five-year wait.

Question 4

How does immigration status affect insurance availability?

Accepted Answer

Qualified non-citizens have ACA access. Undocumented residents cannot use ACA Marketplace but may access community health centers and some state programs.

Question 5

When is Open Enrollment for 2026?

Accepted Answer

November 1, 2025 – January 15, 2026. Outside that window you need a qualifying life event.

Question 6

What is a qualifying life event?

Accepted Answer

A qualifying event opens a 60-day Special Enrollment Period — marriage, baby, moving, losing job-based coverage, or becoming a U.S. citizen.

Question 7

How long does enrollment take?

Accepted Answer

Most families are enrolled within 7–14 days from the first call. Some Medicaid/CHIP approvals can take 30–45 days.

Question 8

What's the difference between Bronze, Silver, Gold, Platinum?

Accepted Answer

Metal tiers describe how costs are split. Bronze = lowest premium, highest deductible. Platinum = highest premium, lowest out-of-pocket. Silver is the only tier eligible for cost-sharing reductions.

Question 9

Can I keep my doctors if I change plans?

Accepted Answer

It depends on the new plan's network. We cross-check your current doctors before you enroll.

Question 10

In-network vs out-of-network — what's the difference?

Accepted Answer

In-network providers have negotiated rates with your carrier. Out-of-network costs more; HMOs usually don't cover out-of-network except in emergencies.

Question 11

What documents do I need to enroll?

Accepted Answer

Typically green card or visa, Social Security number (if you have one), I-94, and proof of income (pay stub or tax return).

Question 12

Do I need an SSN to start?

Accepted Answer

No. You can start the conversation without an SSN. SSN is only required at enrollment, and only for household members who have one.

Question 13

What if I don't have my I-94?

Accepted Answer

You can download it from i94.cbp.dhs.gov. Your advisor can walk you through it.

Question 14

How much does ACA insurance cost per month?

Accepted Answer

Before subsidies: $89–$500+/month depending on age, ZIP, and tier. After ACA premium tax credits, many families pay $0–$200/month.

Question 15

Do I qualify for a subsidy?

Accepted Answer

If household income is 100%–400% of the Federal Poverty Level, yes. Above 400% you may still qualify for partial subsidies through 2025 enhanced credits.

Question 16

Deductible vs out-of-pocket maximum?

Accepted Answer

Deductible is what you pay before insurance shares costs. Out-of-pocket maximum is the most you'll ever pay in a year before insurance covers 100%.

Question 17

What is a copay vs coinsurance?

Accepted Answer

Copay = fixed dollar amount ($30 for a doctor visit). Coinsurance = percentage (20% of $1,000 = $200).

Question 18

Can I add dental and vision to my health plan?

Accepted Answer

Most adult ACA plans don't include dental or vision — they're separate, starting at $19/mo dental and $12/mo vision. Children's dental and vision are included by law.

Question 19

What is an HSA?

Accepted Answer

A Health Savings Account paired with a High-Deductible Health Plan. Pre-tax contributions, tax-free withdrawals for medical expenses. 2025 limits: $4,150 individual / $8,300 family.

Answers, in plain language.

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