Frequently Asked Questions

Get Clear, Honest Answers About Medicare and Health Insurance.

INSURANCE DOSEN'T HAVE TO BE CONFUSING

At You Need Healthcare Insurance, we’re here to help you every step of the way.
Here are answers to some of the most common questions about Medicare, Marketplace plans, and your coverage options.

If you don’t see your question listed, give us a call — we’ll gladly walk you through your situation and find the right plan for you.

Medicare Questions

What is Medicare?

Medicare is a federal health insurance program for people aged 65 and older and for some younger individuals with disabilities. It helps cover hospital stays, doctor visits, preventive care, and prescriptions — and depending on your plan, may even include dental, vision, and hearing benefits.

What’s the difference between Original Medicare and Medicare Advantage?

Original Medicare (Parts A & B) is provided by the government and covers hospital and medical services.
Medicare Advantage (Part C) is offered by private companies and combines Parts A, B, and usually D (drug coverage) into one plan. Many Advantage plans also include extra benefits like dental, vision, hearing, and gym memberships.

We’ll help you compare both options and choose what works best for you.

When can I enroll or make changes to my Medicare plan?

You can enroll or change your plan during the Annual Enrollment Period (October 15 – December 7).
However, certain life events — like moving or losing other coverage — may qualify you for a Special Enrollment Period.
We’ll check your eligibility and make sure you don’t miss your window to update or switch plans.

Can I keep my doctor with a Medicare Advantage plan?

In many cases, yes. We’ll help you find a plan that includes your preferred doctors and specialists in-network so you don’t have to change providers.

What companies do you work with for Medicare?

We proudly work with top-rated carriers, including:
HealthSpring, United Healthcare, Aetna, Prominence, WellCare, and Humana.

Marketplace (ACA) Questions

What is the Health Insurance Marketplace?

The Marketplace is a government-run platform where individuals and families under 65 can compare and purchase health insurance plans. It’s ideal for those who don’t get insurance through work, are self-employed, or need more affordable coverage.

You may also qualify for financial assistance that lowers your monthly premiums or out-of-pocket costs.

Who qualifies for Marketplace coverage?

Most U.S. citizens and legal residents can apply, especially if you don’t have access to job-based insurance or Medicare.
Your eligibility for discounts depends on your household income and family size.

What do Marketplace plans cover?

All Marketplace plans include essential health benefits, such as:

Doctor visits and preventive care
Hospital stays and emergency services
Prescription medications
Maternity and newborn care
Mental health services
Rehabilitative and therapy services
Lab work, imaging, and more

When can I apply for Marketplace insurance?

The Open Enrollment Period runs from November 1 to January 15 each year.
If you’ve had a major life change (marriage, new baby, job loss, relocation, etc.), you may also qualify for a Special Enrollment Period that lets you apply outside those dates.

Which insurance companies do you work with for Marketplace plans?

We offer plans from Blue Cross Blue Shield and Ambetter, both trusted names in healthcare coverage.

General Questions

How much does it cost to work with you?

Our services are completely free to you. We’re paid directly by the insurance companies, so you get the same great rates — plus personalized help and ongoing support.

How do I know which plan is right for me?

That’s what we’re here for! We’ll sit down with you, review your doctors, prescriptions, and budget, and recommend plans that fit your exact needs.
We’ll even compare options from multiple companies so you can make an informed choice.

What if I already have insurance but want to see if there’s something better?

We can review your current plan to see if there’s a way to save money, gain benefits, or simplify your coverage. Many clients discover better options once we compare plans side-by-side.

What are your business hours?

Monday – Friday:

8:00 AM – 4:00 PM

Office: 715 North Main Street, La Feria, TX

Appointments outside these hours are available upon request.

Why should I work with an independent agent?

Independent agents like Eloy Gomez work with multiple insurance companies — not just one. That means you get unbiased advice, better plan comparisons, and ongoing support every year, not just during signup season.

Ready To Be Covered?

We’re Just a Call Away.

Whether you’re enrolling for the first time or just want to better understand your options, we’re here to help — at no cost to you.
Our goal is to make sure you’re covered, confident, and cared for.

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