X

About Us

Our job is not to sell insurance; it’s to help our clients make an educated decision about their health insurance options.

Contact Us

[contact-form-7 id="25" title="Sidebar Form"]

ACA and Short-Term Medical Insurance

Flexible Coverage Options Depending on your Situation

ACA short term medical insurance in Florida

What is ACA / Obama Care?

  • If you’re looking for ACA health insurance in Florida, you’re in the right place. The Affordable Care Act (commonly known as Obamacare) is a federal law that expanded access to health coverage for millions of Americans. Whether you’re self-employed, between jobs, or simply don’t have access to employer coverage, the ACA marketplace may have an affordable option for you.
  • Here’s what the ACA guarantees every enrollee:
  • Coverage for pre-existing conditions. Insurers cannot deny you or charge you more because of a health condition like diabetes, asthma, or high blood pressure.
  • Essential health benefits. All ACA plans must cover preventive care, prescription drugs, emergency services, and mental health treatment.
  • Dependent coverage until age 26. Young adults may be able to stay on a parent’s plan while getting established.
  • Financial assistance based on your income. Depending on your household size and income, you may qualify for premium tax credits that significantly reduce your monthly cost.
  • When the ACA Works and When It Doesn’t
  • For many Floridians, ACA coverage with subsidy assistance is an excellent and affordable solution. But it’s not a perfect fit for everyone. If your income is below or exceeds the subsidy threshold, your unassisted premium can be surprisingly high. The subsidy eligibility can shift as your income or household situation changes year to year.
  • That’s why we don’t just point you to the marketplace and walk away. We look at your full picture: income, household size, coverage needs, and budget; and tell you honestly whether an ACA plan makes sense or whether another option might serve you better.
  • Working With a Local Broker Costs You Nothing
  • At Capstone Health, we’re a local, independent insurance agency right here in New Port Richey. We represent a wide range of Florida ACA health plans and help you compare options side by side, at no cost to you. Unlike an online marketplace or call center, you’ll work directly with an experienced broker who knows Florida’s health insurance landscape and is available year-round when you have questions.
  • We also assist clients in Georgia through our referral network, contact us to learn more.
Book an Appointment

Who's Eligible for Coverage?

To be eligible to enroll in a Marketplace plan, you must qualify. However, even if you meet the eligibility criteria, you're not eligible to get a Marketplace plan if you're eligible for Medicare or Medicaid coverage.

Be a U.S. Citizen or National/Lawfully Present

Have income above 100% of the federal poverty level

Live in the U.S. & Not be incarcerated

Factors to Compare Between Plans

Look at each plan’s network and determine if your preferred providers are in-network. If your doctor is not in-network with a plan you are considering but you want to continue to see them, you may want to consider a different plan. You can always ask your doctor directly if they take the health plan you’re considering. If you don’t have any preferred providers, look for plans with large networks and doctors near you, or contact us as your health insurance broker and we can find one for you.
Examine the out-of-pocket cost differences between plans, including the deductible, copayments, and coinsurance of each plan. While a low premium can be appealing, it may lead to higher out-of-pocket costs, especially if you have a chronic condition or frequently need emergency care or extra visits with a doctor. However, if you know you’re in good health and don’t often need medical care, paying a higher premium may not be the right fit for you. Balance cost and coverage according to your financial and medical needs.
While benefits are not often as important as a factor as network and cost are, it can be helpful in narrowing down your options. Compare the summary of benefits for each plan option you’re considering. See if any of your plans offers a wider range of services, like coverage for mental health care, fertility treatments or emergency coverage. If so, you’ll want to choose the plan with the benefits that help you and your family the most. Please contact us as your health insurance broker to assist you with your decision should you need it.

What are the Four “Metal” Categories?

  • Plans on the Health Insurance Marketplace are presented in four metal categories: All metal plans cover the same set of essential health benefits and do not affect the quality of care you’ll receive. The categories are based on how you and the plan will share the costs for health care services.
Platinum plans generally have the highest premiums but the lowest costs when receiving care. These plans are a good choice if you need a lot of care and can afford a high monthly premium.
Gold plans have a high premium and low costs when receiving care. These plans are a good choice if you need a lot of care.
Silver plans have a moderate premium and cost when receiving care. If you qualify for cost-sharing reductions, you must select a Silver plan to get the “extra savings.” These plans are a good choice if you’re willing to pay more for your care to have a lower premium, or if you qualify for extra savings.
Bronze plans typically have the lowest premiums but the highest deductibles and other out-of-pocket costs. These plans are a good choice if you want peace-of-mind protection from worst-case medical issues.

When can you enroll or make plan changes?

Can you change outside of these dates?

You may still be able to enroll in an ACA health plan outside of the Open Enrollment Period if you qualify for a Special Enrollment Period (SEP). SEPs are triggered by certain life events, such as getting married, having a baby, losing other health coverage, or moving to a new county or state. In addition, households with income at or below 150% of the federal poverty level may qualify for a year-round Special Enrollment Period, as long as they’re eligible for a $0 premium Marketplace plan. Eligibility is determined by the Marketplace and may require income verification. To learn more about your enrollment options, or to get help comparing plans, you can consult a licensed health insurance broker for personalized guidance.

Book an Appointment
Short term medical bridges the gap in health insurance coverage.

Short Term Medical Insurance

  • Short-term medical insurance is temporary health coverage designed for people who are generally healthy and find themselves in a gap between plans. It’s not a replacement for comprehensive coverage, but for the right person at the right time, it can provide real financial protection when you need it most.
  • These plans typically offer lower monthly premiums than unsubsidized ACA coverage, making them a practical option if you don’t qualify for marketplace subsidies and full-price ACA premiums aren’t in your budget.
  • Short-term coverage is commonly used by people who are:
    • Between jobs and without employer-sponsored insurance
    • Waiting for new employer coverage to begin
    • Past the Open Enrollment window and unable to qualify for a Special Enrollment Period
    • Waiting for Medicare eligibility to begin
    • Simply looking for a lower-cost option while their situation stabilizes
  • Short-term plans can help cover unexpected medical expenses like emergency room visits, hospital stays, and surgeries. Many plans also allow you to add optional riders — such as accident or hospital indemnity coverage — for an additional layer of financial protection.
  • A few important things to know: Short-term medical plans are not ACA-compliant. They may include waiting periods, benefit caps, and limitations on pre-existing conditions. We’ll always walk you through exactly what a plan covers and doesn’t cover before you enroll — no surprises.

Who is Short Short Medical Right for?

  • Short-term medical insurance may be a good fit if you:
  • Need temporary coverage during a life transition
  • Are generally healthy with no ongoing medical conditions
  • Want a lower monthly premium than unsubsidized ACA coverage
  • Missed Open Enrollment and don't qualify for a Special Enrollment Period
  • Understand this plan is not ACA-compliant and has benefit limitations
  • Are comfortable with underwriting and potential pre-existing condition exclusions
  • Want the option to add accident or hospital indemnity riders for extra protection

Not Sure Which Option Is Right for You?

  • Short-term medical plans are not the right fit for everyone – particularly if you need comprehensive coverage, manage ongoing health conditions, or require protection for pre-existing conditions. That’s why we never push a plan just because it’s available. We look at your full situation and help you find what actually makes sense.
  • Sometimes the answer is an ACA plan. Sometimes it’s short-term medical to bridge a gap. And sometimes it’s neither – or a combination of both.
  • For example: if you’re generally healthy, don’t qualify for a subsidy, and prefer to pay out of pocket at the doctor, a full-price ACA plan may feel like overkill. Or maybe you’ve opted for a short-term plan but the deductible is high enough that one unexpected medical event could still hit your wallet hard.
  • In both situations, ancillary and supplemental coverage can help. These products are designed to pay you directly when you have a covered medical event – helping offset costs like hospital stays, unexpected diagnoses, or accidents – regardless of what other coverage you have in place.
  • 👉 Learn more about ancillary and supplemental coverage options →
  • Comparing your options doesn’t have to be complicated. Use our Manhattan Life quote tool to instantly view short-term medical plans and rates available in your area – no obligation, no pressure.
  • 👉 Get Your Free Quote →
Book an Appointment

Find Local, Reliable Medicare Help

Whether you're preparing for Medicare, reviewing your current coverage, or looking for personalized guidance, choose the next step that's right for you.

New to Medicare?

Learn when to enroll, understand your Medicare options, and avoid common enrollment mistakes with our step-by-step resources.

Learn About Medicare

Already Have Medicare?

Plans, prescriptions, doctors, and health needs change. Having the right independent Medicare agent helps ensure your coverage continues to fit your needs year after year.

Value of Annual Reviews

Medicare Can Be Easy

Speak with one of our independent Medicare agents by phone, virtually, or in person. Get honest answers and personalized guidance tailored to your needs.

Book an Appointment

Questions before scheduling?

Contact Us Meet Our Team