Frequently Asked Questions

Advanced Premium Tax Credits (APTC) are paid directly by the federal government to your chosen insurance carrier to lower your monthly premium. Eligibility depends on your household size and estimated annual taxable income. Over 80% of applicants qualify for plans under $10/month.

Cost-Sharing Reductions are extra federal savings that lower the amount you pay out-of-pocket for deductibles, copayments, and coinsurance. You qualify for CSR if your income falls between 100% and 250% of the Federal Poverty Level and you enroll in a Silver tier health plan.

- HMO: Requires a designated Primary Care Physician (PCP) who coordinates referrals to specialists within a contracted local network. Lowest premiums and predictable flat copays.
- PPO: Allows you to visit any doctor or specialist nationwide without referrals (including partial out-of-network reimbursement) at higher premium rates.
- EPO: Provides specialist access without PCP referrals but strictly limits coverage to contracted in-network providers (except emergencies).

Under federal law (the ACA and the No Surprises Act), true life-threatening emergencies are covered at in-network cost-sharing levels at any emergency room across the United States, regardless of whether the hospital participates in your health plan's network.

No, never. Working with Prime Health Global is 100% free with our No-Cost Broker Guarantee. Insurance rates are set and regulated by state insurance commissions. Plans cost the exact same whether you enroll directly with the insurer, on HealthCare.gov, or with our licensed brokers.

Yes! Our advisors utilize proprietary provider lookup tools to cross-reference your primary care doctors, specialists, and daily medication tier formularies before finalizing your enrollment.

Medical indemnity insurance pays predetermined lump-sum cash directly to you (not the medical facility) whenever you experience a hospital stay, surgery, or ER visit. You can use these cash funds to pay your major medical plan's high deductible or cover household bills while recovering.