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HEALTH (ACA) · MARKETPLACE · MEDICAID TRANSITIONS

Enrolled with you, in your language.

Every plan where you live, with your doctors and prescriptions checked before you enrol.

Where premium help starts and stops, by household income An income scale measured as a percentage of the federal poverty level. Below 100 per cent there is no premium help, a rule that changed in 2026. Between 100 and 250 per cent there is premium help and cost-sharing reductions, which attach only to Silver plans. Between 250 and 400 per cent there is premium help but no cost-sharing reductions. Above 400 per cent there is no premium help at all, with no taper. 0% 100% FPL 250% 400% FPL and above No help Most help Premium help only No help $15,650 for one person $32,150 for a family of four roughly $62,600 for one person one dollar over removes all of it
  • Most helpPremium help plus cost-sharing reductions, which lower your deductible and copays. They attach only to Silver plans, which is why the cheapest premium is often not the cheapest year.
  • Premium help onlyThe premium is reduced. Deductibles and copays are whatever the plan says.
  • No premium helpBelow the poverty level since the 2026 rule change, and above four times it since the income cap returned. There is no taper at the top: one dollar over the line removes all of it.

Federal poverty figures are the 2026 guidelines for the 48 contiguous states; the 400% figure is four times the one-person guideline and is shown as an approximation. Eligibility is determined by the Marketplace, depends on household size, age and county as well as income, and changes annually. This is educational information, not a determination. Check yours at healthcare.gov or ask us to run it.

WHAT IT COSTS, WITH REAL NUMBERS

Two households we enrolled.

Nobody can quote you from a web page. But "it depends" is not an answer either, so here are two actual outcomes and what drove them.

Situation
A mother of three lost Medicaid because she picked up a part-time job. The extra income pushed her over the Medicaid line and left her, on paper, worse off for working.
What she pays
An estimated $47 a month for a Silver plan, with a $0 deductible.
Why
Her income landed in the band where the premium subsidy is largest and cost-sharing reductions also apply. Those reductions only attach to Silver plans, so choosing Bronze to save on the premium would have cost her far more the first time she used the plan.
After
She brought both her sisters in the following week.
Situation
A family needed their son covered before knee surgery.
What they pay
An estimated $110 a month for a cost-sharing-reduction Silver plan, with a $0 deductible and a $1,600 annual out-of-pocket maximum.
Why it mattered
The out-of-pocket maximum is the number that decides what a surgery costs you. Theirs was capped at $1,600 for the whole year, so an operation that would otherwise have been financially serious was not.
The lesson
The cheapest monthly premium and the cheapest year are frequently different plans. We show you both figures before you choose.

Estimated figures from actual enrolments, shown to illustrate how subsidies and cost-sharing work. They are not a quote and not a prediction for your household: your premium depends on your income, household size, age, county and the plan you choose. No client is identified.

RULE CHANGES YOU WILL FEEL

Three things changed, and one is still coming.

The subsidy rules moved in 2026, and they move again for 2027. If you were comfortable last year, that is not evidence you are fine this year.

Federal rules as of the review date on this page. Confirm your own situation at healthcare.gov.
What changedWhenWho it hits
The enhanced subsidies expired January 1, 2026 Everyone. Premium help reverted to the smaller original formula, and most families renewing this year saw their monthly payment rise.
The income cap returned January 1, 2026 Households above four times the federal poverty level now get no premium help at all. There is no taper: one dollar over the line removes all of it.
The below-poverty exception ended January 1, 2026 Lawfully present immigrants earning under the poverty level, including people inside Medicaid's five-year wait. Premium help now requires income at or above the federal poverty level, which is $15,650 for one person and $32,150 for a family of four.
Premium help narrows by status 2027 plan year Refugees, asylees, people with TPS and several other humanitarian statuses lose premium tax credits, even with qualifying income. They may still buy Marketplace plans, at full price.

If you are a refugee or asylee on a subsidised plan today, the enrolment window in autumn 2026 is your decision point for 2027, and it is worth using rather than letting the plan roll over. The full breakdown is here, and there is a free estimator for the repayment side.

Educational information only, not legal or tax advice. Eligibility rules are federal and change; a licensed advisor should look at your household before you act on any of this.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE (1-800-633-4227), 24 hours a day / 7 days a week, to get information on all of your options. Kivulink Insurance Services is not affiliated with or endorsed by any government agency or the federal Medicare program.

THE DEADLINE PEOPLE MISS

Losing coverage starts a 60-day clock.

Open Enrollment runs from November 1 to January 15, and outside it you generally cannot buy a Marketplace plan.

The exception is a qualifying life event: losing Medicaid, losing a job's coverage, moving, marrying, having a baby. Any of those opens a Special Enrollment Period of 60 days.

Sixty days sounds generous and it is not.

The clock starts when the coverage ends, not when you notice, and the paperwork proving the event takes time to gather. Many Texans lost Medicaid this year and found out weeks later. Call us the week it happens rather than the month after, because the window does not extend and there is nothing anyone can do once it closes.

Call 832-775-2509

Health coverage questions, answered.

Can I get a Marketplace plan without a Social Security number?
Lawfully present immigrants can buy Marketplace coverage and may qualify for premium help, and there are several statuses that count.

What you can get depends on your specific status and income rather than on whether you hold an SSN. Bring your documents and we will tell you where you stand.

Why would a Silver plan beat a cheaper Bronze one?
Cost-sharing reductions attach only to Silver. For a household that qualifies, Silver can carry a lower deductible and a much lower out-of-pocket maximum than Bronze while costing a little more each month.

We check this every time, because it is the most common expensive mistake people make on their own.

Will my doctor and my prescriptions be covered?

We check both before you enrol, by name and by drug. Networks and formularies change every January even when your plan name does not, which is why the October review exists.

What does using an agent cost me?

Nothing. The price of a Marketplace plan is set and is identical whether you enrol through us, through healthcare.gov, or through the carrier. Our commission comes from the carrier.

What happens if my income changes mid-year?

Report it. Your subsidy adjusts from that point, which is far better than discovering the gap on your tax return in April. We handle the update, and we prepare the tax return that reconciles it if you want that in one place.

Do you speak my language?

Our advisors work in English, Kinyarwanda, Kiswahili, French, Kirundi, Spanish, Dari and Pashto. For other languages you are welcome to bring an interpreter and we will take the time it needs.

Marketplace carriers we hold 12+

  • UnitedHealthcare
  • Blue Cross Blue Shield
  • Blue Cross Blue Shield of Tennessee
  • Aetna CVS Health
  • Anthem
  • Cigna
  • Ambetter
  • Oscar Health
  • Wellpoint
  • Molina Healthcare
  • Community Health Choice
  • Imperial Insurance

One application is rated by all of them. Appointments vary by state and no carrier writes every product everywhere. See the full network.

See what you qualify for.

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NPN 22182172 Licensed in 10 states: TX · TN · AZ · CO · IN · KY · ME · MI · OH · WI Independent. Appointed by carriers, owned by none of them
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