Health insurance products
Tempest Health Agency's licensed agents help you compare four kinds of coverage. Every sale is made by a licensed agent. Plans are issued by insurance carriers and benefit administrators, not by us, and not every plan is available in every state.
Call 1-888-673-1264 to talk with an agent, or use our contact form.
ACA Marketplace plans
Major medical plans sold through the Health Insurance Marketplace under the Affordable Care Act.
What every Marketplace plan covers. The ten essential health benefits:
- Doctor visits and outpatient care
- Emergency services
- Hospital stays
- Pregnancy, maternity and newborn care
- Mental health and substance use disorder services
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Lab tests
- Preventive and wellness care, and chronic disease management
- Children's services, including dental and vision care
Marketplace plans cannot turn you down or charge you more because of a pre-existing condition.
Plan levels. Marketplace plans come in metal levels that split costs differently between you and the plan:
- Bronze: lowest monthly premium, highest costs when you get care.
- Silver: moderate premium and moderate costs.
- Gold: higher premium, lower costs when you get care.
- Platinum: highest premium, lowest costs when you get care. Not sold in every area.
Who can enroll. You generally need to live in the United States, be a U.S. citizen or national or be lawfully present, and not be incarcerated. People enrolled in Medicare generally cannot buy a Marketplace plan.
When. During open enrollment each fall, or during a special enrollment period after a qualifying life event such as losing other coverage, moving, getting married or having a baby.
Cost. Your premium depends on where you live, your age, tobacco use, who is on the plan and the plan level. Depending on household income, you may qualify for help with premiums through the Marketplace. Your agent checks this with you.
Private health plans
Plans sold by insurance companies and benefit administrators outside the Marketplace.
- These are not ACA plans. They do not have to cover all essential health benefits, and they may ask health questions, exclude pre-existing conditions or limit benefits.
- Depending on the plan, benefits may be paid as set dollar amounts for services such as doctor visits and hospital stays, or may work through a provider network.
- Some plans carry an enrollment or membership fee set by the carrier. Your agent tells you the full cost before you enroll.
- Your agent explains what a plan does and does not cover before you decide.
Short-term medical
Temporary coverage for a gap, such as between jobs or while you wait for other coverage to start.
- Short-term plans are not ACA plans. They may not cover pre-existing conditions or every essential health benefit, and they may have benefit limits.
- Approval depends on your answers to health questions.
- How long a plan can last depends on federal and state rules. Your agent tells you what applies where you live.
Supplemental products
Products that add to your main coverage. None of them replace major medical coverage.
- Identity protection: monitoring, and help if your identity is stolen.
- Discount health programs: discounts on services such as vision and wellness care at participating providers. Discount programs are not insurance. You pay the provider directly at the discounted rate.
Before you buy: questions to ask
- Is this an ACA plan?
- If the plan has a network, are my doctors and hospitals in it?
- Are my prescriptions covered?
- Are pre-existing conditions covered, and is there a waiting period?
- What is the deductible, and what is the most I could pay in a year?
- Is there an enrollment or membership fee?
Your agent answers each of these before you enroll.
After you enroll
Your carrier handles claims and ID cards. The claims phone number is on your insurance card. If you are not sure whom to call, call us at 1-888-673-1264 and we will point you to the right place.
Tempest Health Agency is not affiliated with or endorsed by any government agency, including the Health Insurance Marketplace. Discount health programs are not insurance.