Health Coverage · ACA
Obamacare (ACA) explained clearly, in your language
Obamacare (the ACA, or Affordable Care Act) is health insurance with government help based on your income. We explain how it works and walk you through enrolling, at no cost for the guidance.
10
essential benefits covered by every plan
$0/mo
possible on your premium if you qualify for a subsidy
3
plan tiers: Bronze, Silver, Gold and Platinum
What Obamacare (the ACA) is
Obamacare is the common name for the ACA (Affordable Care Act). It's health insurance bought through the Health Insurance Marketplace, and it can include a subsidy: government help called a Premium Tax Credit (PTC) that lowers what you pay each month.
The subsidy amount depends on your income and your household size. That's why two families can pay very different prices for similar plans. When the subsidy is enough, your monthly premium can be as low as $0; if you don't qualify, you pay the plan's price.
Latin Prime Financial Group is an independent insurance agency. We are not the government or the Marketplace, and we don't charge you for guidance: we help you understand your options, compare plan tiers, and enroll correctly.
What changed this season
The enhanced premium tax credits in place from 2021 through 2025 expired at the end of 2025. Who can enroll did not change — what people pay did. These are the official figures.
increase in the average net premium in 2026, from $113 to $178 a month
of household income is now the required contribution, up from 4.56%
of the federal poverty level is again the ceiling: above it, no tax credit
of enrollees receive a tax credit, down from 92% in 2025 — the first drop since 2020
If your premium went up
Don't assume it's a carrier error. Under the new rules a different metal level may suit you better: sometimes a Silver plan with cost-sharing reductions beats the Bronze you had. It's worth rerunning the numbers before you renew.
If you no longer qualify for a tax credit
The 400% ceiling is back, so some households that received help in 2025 don't in 2026. You can still buy a Marketplace plan at full price, and there are options outside the Marketplace. We review it together, at no cost.
If you're thinking of cancelling
Before you stop paying, check the math. Cancelling on your own doesn't give you the right to enroll outside the window: you'd have to wait for the next open enrollment, with no coverage in between.
Figures from KFF's analysis of 2026 Marketplace premiums and from Congressional Research Service report R48290 on the expiration of the enhanced premium tax credit. These are national averages: your own case depends on your income, household and state.
Plan tiers: how they compare
All tiers cover the same 10 essential benefits. The difference is how you split the cost between your monthly premium and what you pay when you use care.
The Marketplace has four tiers — Bronze, Silver, Gold and Platinum — plus Catastrophic plans for people under 30 or with a hardship exemption (healthcare.gov). Above we compare the two most common ends; Platinum is not offered in every area. Silver sits in the middle and often works out well if you qualify for extra help with copays and deductibles (CSR). In your consultation we review which tier fits your situation best.
How we enroll you
A clear process, in Spanish or English, with no cost for the guidance.
Free consultation
You tell us your situation and we answer your questions, with no obligation or pressure.
We review income and household
Using your income and family size, we estimate whether you qualify for a subsidy and how much.
We compare plans
We look at the tiers available in your area and choose the one that best fits your budget and your health.
Enrollment and follow-up
We help you enroll correctly and stay available if you need to make changes during the year.
The 10 essential health benefits every plan covers
These are not ten things one plan or another chose to include: they are the minimum the law requires of EVERY Marketplace plan. If a plan does not cover them, it is not a Marketplace plan.
Ambulatory patient services: outpatient care you get without being admitted to a hospital.
Emergency services.
Hospitalization, including surgery and overnight stays.
Pregnancy, maternity and newborn care, before and after birth.
Mental health and substance use disorder services, including counseling and psychotherapy.
Prescription drugs.
Rehabilitative and habilitative services and devices, to gain or recover mental and physical skills.
Laboratory services.
Preventive and wellness services and chronic disease management.
Pediatric services, including oral and vision care for children.
Official list from HealthCare.gov (healthcare.gov/coverage/what-marketplace-plans-cover), verified September 17, 2026. Plans must also include birth control and breastfeeding coverage. What each category covers exactly can vary by state. Adult dental and vision are NOT essential health benefits: some plans include them, some do not.
In three of the states we serve, the rules are different
Texas, Florida and Georgia did not expand Medicaid. If you live in one of them there is a hole almost nobody explains, and it can leave you with nothing precisely because you earn too little.
It is called the COVERAGE GAP: if you earn LESS than the federal poverty level and do not qualify for your state's Medicaid, you do not qualify for marketplace help either. Earning too little locks you out of both doors at once.
In a state that did expand Medicaid, that same person with that same income would have coverage. The difference is not your situation: it is the state line.
This is not a marginal case. According to KFF, Texas (25%), Florida (18%) and Georgia (10%) account for 53% of everyone in the country who is in that gap — more than half, in three states.
It shows in people's health: states that did not expand Medicaid have nearly twice the uninsured rate of those that did — 14.5% versus 8.0%, per KFF.
If you fall in the gap, the marketplace gives you nothing — but you are not out of options. We offer PRIVATE HEALTH PLANS, from major medical to limited-benefit everyday plans. Availability varies by state, and at your appointment a benefits consultant on Carlos J. Torres's team reviews which one fits you; if you qualify for a good ACA subsidy, we tell you.
In the other states we serve, Medicaid rules are different, and each state has its own marketplace, its own dates and its own children's programs. Your state's page has the detail that applies to you.
We are licensed in all 50 states and Puerto Rico, and the office is in Doral, Miami-Dade County. If you are nearby and would rather sit down in person, that works; if not, everything can be done by phone or video.
Coverage gap figures: KFF (Kaiser Family Foundation). Medicaid expansion status can change if legislation or a ballot amendment advances in any state, and we will update this page when it does. This is educational guidance, not an eligibility determination: your case is evaluated with your numbers and your state.
What every ACA plan covers
- No denial or higher price for pre-existing conditions (diabetes, high blood pressure, pregnancy, and more)
- Preventive care included at no extra cost within the plan's network
- Possible subsidy that lowers your monthly premium based on your income
- Four plan tiers (Bronze, Silver, Gold and Platinum); we compare the ones available in your area
- Support in Spanish or English before, during, and after you enroll
Requirements to enroll
- Live in the United States.
- Be a U.S. citizen or national, or a lawfully present immigrant.
- Not be incarcerated.
- If you already have Medicare, you cannot enroll in a Marketplace health or dental plan.
Common Obamacare myths
Let's be clear: a lot of what you hear isn't true.
"It's completely free for everyone."
Not always. It can be as low as $0/month if your subsidy covers the premium, but that depends on your income and household; it isn't automatic for everyone.
"They'll deny me because of my health."
No. ACA plans can't deny you or charge you more for pre-existing conditions.
"It's too expensive."
Many families pay far less than they expect thanks to the subsidy. It's worth running your own numbers before ruling it out.
"I can only enroll once and I already missed it."
There's an open enrollment each year, and if you have a qualifying life change (job loss, a move, marriage, a new baby) you can enroll during a Special Enrollment Period (SEP).
Is Obamacare right for you?
It makes sense if
- You don't have health coverage through your job
- You're self-employed, an independent worker, or a small-business owner
- Your income could qualify you for a subsidy that lowers the premium
- You want full coverage that won't deny you for a pre-existing condition
- You want someone to explain your options in your language, with no pressure
You may not need it if
- You already have good health coverage through your employer
- You qualify for Medicaid or Medicare (we'll point you to the right option)
- You're only looking for a discount card, not real health insurance (the ACA is full coverage)
Free consultation
Talk to an advisor, free and in your language
Leave your info and a licensed advisor will contact you to review your options. No obligation.
- 100% free consultation, no obligation
- We help you in Spanish or English
- We reply within 24 hours
Tell us your case
Fill out the form and we will contact you for your free consultation.
Frequently asked questions
Why did my Obamacare premium go up this year?
It most likely isn't an error. The enhanced premium tax credits in place from 2021 through 2025 expired at the end of 2025, and the required household contribution went back up under the earlier rules. The average net premium rose 58% nationally. Your own case depends on your income, household and state, and it's worth rerunning the numbers before you renew: sometimes a different metal level works out better.
I earn above 400% of the federal poverty level — do I have options?
Yes, even without a tax credit. Between 2021 and 2025 there was no ceiling and many people above 400% received help; that ceiling is back. You can buy a Marketplace plan at full price, and there are also options outside the Marketplace with more predictable costs. Which one fits depends on your health and how much you use your coverage; we review it with you at no cost.
Is health insurance mandatory? Will I be fined without it?
At the federal level, no. HealthCare.gov states it plainly: the fee for not having health insurance no longer applies, so you no longer pay a federal tax penalty for not having coverage. Note that some states have their own rule, so confirm based on where you live. No penalty does not mean no need: an emergency without coverage is paid in full.
I am undocumented. Can I enroll?
No. HealthCare.gov is explicit: undocumented immigrants cannot get Marketplace health coverage. But here is something many people do not know and that does matter: they CAN apply for coverage on behalf of documented family members. If your household has mixed statuses, do not give up on coverage for your children or your spouse — it is worth reviewing.
When does enrollment open for 2027?
Open Enrollment for 2027 coverage starts November 1. Outside that window you can only enroll with a Special Enrollment Period triggered by a life change — moving, losing other coverage, marriage or a new baby, among others.
Is Latin Prime part of the government or the Marketplace?
No. We're an independent insurance agency. We guide you and help you enroll, but we are not the government or the Marketplace.
How much does your help cost?
The guidance is free to you. We help you compare plans and enroll without charging you for that service.
Can it really be $0 a month?
It's possible if you qualify for a subsidy that covers your full premium. It depends on your income and household size; we calculate it with you in the consultation.
Can I be denied for a pre-existing condition?
No. ACA plans cover pre-existing conditions and cannot deny you coverage or charge you more because of them.
When can I enroll?
There's an open enrollment once a year. Outside that window, you can enroll if you have a qualifying life event through a Special Enrollment Period (SEP).
What do I need to get started?
Just a rough idea of your annual income and how many people live in your household. With that we estimate your subsidy and your options.
How do I apply for Obamacare in Miami or anywhere in Florida?
Florida uses the federal marketplace, so enrollment happens at healthcare.gov — the same site whether you live in Miami, Orlando, Tampa or anywhere else in the state. There is no Florida state marketplace. You can do it on your own, or with a licensed agent who charges you nothing: the marketplace pays the carrier, not you. Our office is in Doral, Miami-Dade, if you would rather not do it alone.
Is Obamacare different in Florida than in other states?
Yes, and it matters. Florida did not expand Medicaid, so there is a hole: someone earning LESS than the federal poverty level can end up with neither Medicaid nor marketplace help. It is called the coverage gap, and per KFF, Florida accounts for 18% of everyone in the country who is in it. In a state that did expand, that same person would have Medicaid. That is why it pays to check the numbers before assuming anything.
Educational content. Latin Prime Financial Group is an independent insurance agency; it is not affiliated with the U.S. government or the Health Insurance Marketplace. Plan availability, prices, and subsidy (tax credit) eligibility are determined by the Marketplace based on your income, household, and state, and are confirmed at the time of enrollment. This is not legal, tax, or medical advice.
If the marketplace is not for you
There are two situations the ACA does not solve, and both have a route.
Find out how much you could save on your health coverage
Book a free consultation and we'll tell you, based on your income and household, which subsidy and plan you could qualify for.
Prefer to text? Send us your question on WhatsApp (689) 800-8978. If you then want an appointment, we set it up with you on Zoom.