Frequently asked
questions

Frequently
asked
questions

General

What languages do you speak?

We speak Ukrainian, Russian and English.

Where are you located? What are your office hours?

Our headquarters is located in Matawan, NJ. Our office hours are typically 9:00 AM to 5:00 PM EST, Monday to Friday.

Is it nessecary to meet in the office? Is it safe to submit documents online?

It’s not necessary to meet in the office. We offer consultations by phone or online for your convenience. You can submit all documents securely online, and rest assured that your information will be kept confidential. We guarantee the security of your personal and financial data.

In which states are you working?

Our agency is currently licensed in the following states:

• New Jersey (NJ)

• New York (NY)

• Pennsylvania (PA)

• Virginia (VA)

• Maryland (MD)

• Florida (FL)

• Illinois (IL)

• Texas (TX)

• California (CA)

• Washington (WA)

• Georgia (GA)

• North Carolina (NC)

• South Carolina (SC)

We are always looking to expand. For the most up-to-date information and current availability, please call our office at 908-944-9991.

Do you charge a fee for enrollment or assistance?

No, we do not charge any fees. All our agents services are completely free of charge. We work based on commissions, which are paid by the carriers.

Insurance

What is the best health insurance?

The best health insurance depends on your personal needs, budget, and healthcare requirements. Factors like network of doctors, prescription drug coverage, premium and out-of-pocket costs should all be considered. For many, plans offered through the Health Insurance Marketplace are good options. It’s helpful to compare different plans based on your healthcare needs and financial situation.

What is the Health Insurance Marketplace?

The Health Insurance Marketplace (also known as the Exchange) is a service that helps people shop for and enroll in health insurance. It was created by the Affordable Care Act (ACA) to make it easier for individuals, families, and small businesses to find affordable health coverage. The Marketplace allows you to compare different insurance plans based on factors like cost, coverage, and the network of doctors. Depending on your income and household size, you may qualify for financial assistance, such as subsidies, to lower your monthly premiums or out-of-pocket costs. The Marketplace is available online, and each state may have its own version of the Marketplace, or it may use the federal Marketplace at HealthCare.gov.

What are deductibles, copayments, and coinsurance?

Deductible: The amount you pay for covered health care services before your insurance starts to pay. For example, if your deductible is $1,000, you’ll need to pay that amount first before your insurance covers the rest.

Copayment (Copay): A fixed amount you pay for a covered health care service, usually at the time of service. For example, you might pay $20 for a doctor’s visit, and your insurance covers the rest.

Coinsurance: The percentage of costs you pay for a service after you’ve met your deductible. For example, if your coinsurance is 20%, you pay 20% of the service cost, and your insurance covers the remaining 80%.

What is financial help for health insurance?

Financial help for health insurance, also known as subsidies, is provided through the Health Insurance Marketplace to help lower the cost of health coverage. There are two main types of financial assistance:

Premium Tax Credits – These lower your monthly premium costs based on your income and household size. If you qualify, you can apply the credit directly to reduce your monthly payment.

Cost-Sharing Reductions (CSR) – These reduce your out-of-pocket costs, such as deductibles, copayments, and coinsurance, for people with lower incomes. CSR is available for those who qualify for a Silver plan in the Marketplace.

Eligibility for financial help depends on your income, family size, and whether your state has expanded Medicaid. The Marketplace will determine what financial assistance you qualify for when you apply.

I came to the U.S. through the United for Ukraine program and now have TPS. Am I eligible for health or life insurance?

Yes, as a Temporary Protected Status (TPS) holder or United for Ukraine program (U4U), you may qualify for health insurance through the Health Insurance Marketplace or Medicaid, depending on your income and state of residence. For life insurance, eligibility varies by provider, but you may be able to apply for coverage.

If my income or qualifying life event changes during the year, can I change my health insurance application?

Yes, if your income or qualifying life event changes during the year, you may be able to update your health insurance. Qualifying life events include changes like marriage, divorce, the birth of a child, loss of other coverage, or moving to a new state. Please contact us within 30 days of the change. Keep in mind that any change could affect your policy, including premiums, coverage, or eligibility for subsidies.

What is Form 1095-A?

Form 1095-A is a health insurance statement provided by the Health Insurance Marketplace. It reports the details of your health coverage, including the months you were covered, the premiums paid, and any premium tax credits you received. You’ll need this form when filing your taxes to accurately report your health insurance and claim any applicable subsidies or tax credits.

My insurance premium is so expensive. Why should I have insurance?

While insurance premiums may seem high, having health insurance helps protect you from high medical costs in case of illness, injury, or emergencies. It also provides access to regular care, preventive services, and discounts on medications. Plus, if you qualify for subsidies through the Marketplace, you may be able to reduce your premium costs. Having insurance can save you money and provide peace of mind in the long run.

Is it mandatory to have health insurance? Will I be penalized if I don’t have it?

While there is no federal penalty for not having health insurance, some states have their own health insurance mandates and penalties. These states include:

• California (CA)

• New Jersey (NJ)

• Massachusetts (MA)

• Rhode Island (RI)

• Vermont (for certain individuals)

• District of Columbia (Washington, D.C.)

If you live in one of these states, you may face a penalty if you don’t have insurance. Be sure to check your state's rules to see if the mandate applies to you. Even if you aren't penalized, having health insurance provides important financial protection.

How can I project my annual income for a health insurance application?

To project your annual income for a health insurance application, add up all sources of income you expect to receive in the year, including wages, self-employment income, unemployment benefits, and any other taxable income. If your income varies, use an average from the past few months or the amount you expect to earn in the upcoming months, then adjust for the full year.

Taxes

Should I indicate income before taxes or after taxes?

For W2 employee cases, you should report your gross income before taxes or deductions. For 1099 and self-employed income, the final figure you report may be adjusted after deducting business expenses. Contact your tax accountant for guidance on how to best calculate and report your projected income, especially if you are self-employed or have business expenses.

Why is the tax return important for health insurance through the Marketplace?

Your tax return is important for health insurance through the Marketplace because it helps determine your household income and size, which are used to calculate your eligibility for subsidies, Medicaid, or other financial assistance. The information on your tax return ensures that you receive the correct amount of help with premiums and out-of-pocket costs.

Why should I file taxes for the Health Insurance Marketplace if I’m unemployed and my income was zero?

You must file taxes to report your subsidies and confirm that you have no income. Filing helps ensure that your health insurance subsidies, if applicable, are accurately calculated and that the Marketplace has the correct information about your income.

Medicare

What is Medicare?

Medicare is a federal health insurance program primarily for people aged 65 and older, but it also covers certain younger individuals with disabilities or specific medical conditions. Medicare consists of different parts:

• Part A covers hospital stays, skilled nursing care, and some home health care.

• Part B covers outpatient care, doctor visits, and some preventive services.

• Part C (Medicare Advantage) is an alternative that combines Parts A and B, often with additional benefits like vision or dental coverage.

• Part D provides prescription drug coverage.

Medicare helps reduce the cost of healthcare for eligible individuals, though it may still require premiums, deductibles, and co-pays.

How can I check if I qualify for Medicare?

You can check if you qualify for Medicare by visiting the official Medicare website (medicare.gov or ssa.gov) or by calling the Social Security Administration (SSA) at 1-800-772-1213. Generally, you qualify for Medicare if you’re 65 or older, or if you’re under 65 and have a qualifying disability. To be eligible for premium-free Part A, you must have worked and paid Medicare taxes for at least 10 years (40 work credits). If you don’t have the required work credits, you may still qualify, but you may have to pay a premium for Part A. You can also check your eligibility by reviewing your Social Security status or by receiving an automatic enrollment notice when you turn 65.

Is Medicare free?

Medicare is not entirely free, but it offers affordable health coverage for eligible individuals. Here’s a breakdown of the costs:

• Part A (hospital insurance) is usually premium-free if you’ve worked and paid Medicare taxes for at least 10 years, which means many people don’t have to pay a monthly premium for it.

• Part B (medical insurance) typically has a monthly premium, expected to be around $185 in 2025, but it can vary based on your income. This part covers doctor visits, outpatient services, and preventive care, offering valuable protection against healthcare costs.

• Part C (Medicare Advantage) is an alternative to Original Medicare and often includes extra benefits like dental, vision, or hearing coverage. Some Medicare Advantage plans have a $0 premium, making it an affordable option for many people, though you may still need to pay for Part B.

• Part D (prescription drug coverage) has a monthly premium that can vary depending on the plan, but it helps lower the cost of your medications.

While there are costs, Medicare can provide excellent coverage, and many people find it more affordable than private insurance. You may also qualify for financial assistance programs to help with out-of-pocket expenses, making Medicare even more accessible and cost-effective.

Dental & Vision

Is dental and vision coverage included in health insurance?

Dental and vision coverage is typically not included in standard health insurance plans. However, some health insurance plans offer dental and vision as optional add-ons. If they are not included, you can purchase separate dental and vision insurance for yourself and your family. It’s a good idea to compare different options to find the best coverage for your needs.

What is routine, basic, and major dental coverage?

Each type of dental coverage serves different needs, with routine care typically being the most affordable, and major dental care requiring more coverage and higher costs.

Routine Dental coverage generally includes preventive care such as exams, cleanings, and X-rays. These are typically covered 100% by most dental plans.

Basic Dental coverage includes services like fillings, extractions, and simple repairs. These usually have some cost-sharing, like a co-payment or coinsurance, and are often covered up to 80%.

Major Dental coverage covers more extensive procedures, such as crowns, root canals, bridges, dentures, and oral surgery. These services typically have higher out-of-pocket costs and may be covered at a lower percentage, usually around 50%.

Important: Coverage terms may vary depending on the insurance plan. We recommend carefully comparing your options before enrolling.

Medicaid

What is Medicaid?

Medicaid (also known as Medical in California) is a government program that provides health coverage to low-income individuals and families. It is funded jointly by the federal government and states, and eligibility varies by state. Medicaid covers a wide range of services, including doctor visits, hospital stays, prescription medications, and preventive care. Under the Affordable Care Act (ACA), many states expanded Medicaid to provide health coverage to more low-income adults who weren't previously eligible. This has helped millions gain access to healthcare, making it more affordable for those in need.

I’m a new green card holder. Am I eligible for Medicaid? If not, can I apply for the Marketplace?

As a new green card holder, you may not be eligible for Medicaid right away, as most states require you to have lived in the U.S. for at least 5 years. However, you can apply for health insurance through the Health Insurance Marketplace at any time. Depending on your income, you may qualify for subsidies or other assistance.

I lost Medicaid due to my income. Can I still get affordable health insurance?

Yes, you may qualify for other affordable health insurance options through the Health Insurance Marketplace based on your new income level.

Other

If I receive an unknown letter, should I ignore it?

No, you should not ignore an unknown letter, especially if it’s related to health insurance, taxes, or government programs. It's important to verify the legitimacy of the letter. If you're unsure, it's always best to seek advice from a trusted professional. Our team will assist you in verifying its legitimacy and help you understand any necessary actions you need to take.

Why do I need life insurance?

Life insurance provides financial protection not only in the event of death but also if you become seriously ill. It can help cover funeral costs, outstanding debts, and living expenses for your family. Additionally, some life insurance policies offer living benefits, which allow you to access a portion of the death benefit if you become critically ill. This can help with medical bills, treatment costs, and other financial needs while you're recovering, ensuring you and your loved ones are supported during tough times.

What are out-of-pocket costs?

Out-of-pocket costs are the money you pay for health care services that aren’t covered by your health insurance. This includes things like deductibles, copayments, and coinsurance. These costs are your responsibility, even if you have health insurance.

Do they check medical records for life insurance? How easy is it to get approval?

Yes, life insurance companies may review your medical records as part of the approval process, especially for policies that require a medical exam. They may also ask you health-related questions on the application. The ease of approval depends on factors like your age, health, and the type of policy you apply for. If you’re generally healthy, approval can be straightforward, but if you have pre-existing conditions, it might take longer or result in higher premiums. Some policies, like guaranteed issue or no-exam life insurance, may not require medical records or exams, but these often come with higher premiums or lower coverage amounts.

If I quit smoking, can I get a lower premium for life insurance?

Yes, if you quit smoking and can prove you've been smoke-free for a certain period (usually 12 months or more), you may be eligible for lower premiums. Many life insurance companies offer discounts to non-smokers, so quitting smoking can result in significant savings on your policy over time. It's a good idea to inform your insurer once you’ve quit, as they may require documentation to adjust your premium.

Is an inspection required for home insurance?

An inspection may be required for home insurance, depending on the insurer and the condition of the property. Some insurers require a home inspection to assess the risk and ensure the property meets their coverage standards. However, many insurers offer coverage without a mandatory inspection, especially for newer or well-maintained homes.

What is the best way to add a teenage driver to my current auto policy or have them apply for their own?

Adding teenager to your policy is often more affordable than having them apply for their own. However, if they apply for their own policy, they may face higher premiums due to their age and driving experience. It's a good idea to compare quotes and ask about discounts for good grades, driver’s education courses, or safe driving habits.

Learn more

If you’d like more useful information, please watch the videos below or visit our YouTube channel

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