1 OF 2
ACA QUESTIONNAIRE

Have you experienced a Life Changing Event listed below?

Got Married or divorced

Had a baby, or adopted/fostered a child

Became unemployed or change of income

Moved to a new primary residence

Denied Medicaid or CHIP coverage

Recently gained citizenship or lawful presence in the U.S.

Was released from incarceration (detention, jail, or prison)

Employer offered to help with the cost of coverage either through an individual coverage HRA or QSEHRA

Member of a federally recognized tribe, or an Alaska Native corporation shareholder

I received a notice that I may qualify due to a national or economical event

© 2021-2023 HealthInsurance.com, LLC

Privacy Policy  |  Terms and Conditions

GENERAL DISCLAIMERS

HealthInsurance.com, LLC is a licensed insurance agency. CA License #0D10265. It is not a government agency, insurer, or medical provider.

This advertisement is for Short-Term Medical, Indemnity, and Affordable Care Act (ACA) products.

Individuals can enroll in ACA plans outside designated enrollment periods only if specific conditions are met. Individuals can enroll in a Short Term Medical or Indemnity product if not met. Short-term and limited-benefit medical insurance are not part of the Affordable Care Act (Obamacare). They may not cover pre-existing conditions or all ten essential benefits. Limited Benefit Medical Indemnity Insurance is designed to provide additional benefits to supplement major medical insurance and may not be available in some states without proof of major medical insurance.

If you provide your contact information, a licensed insurance agent may contact you to help you enroll in a Short Term Medical, Indemnity, or ACA product from one of the carriers we represent. Enrollment is not obligated and depends on the plan’s contract renewal. We may direct you to our partner websites for additional assistance. It is essential to carefully review all policies before making a decision.

This site is not affiliated with the government’s Health Insurance Marketplace website or any state government health insurance marketplace. We do not offer every plan available in your area. For more information on how we process your personal information, visit our website and review our privacy policy and notices.