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Items to have ready for your enrollment application either in-person or over the phone:

​>>> For Medicare applicants:  Click Here


Affordable Care Act (aka Obamacare), under age 65, see below.

  • Items needed from all household members including spouse, and other dependents (if not applying for a tax-credit then information for only those individuals needing coverage will be required):

    • Formal full names​ as listed with Social Security

    • Dates of Birth

    • Smoker Status

    • Residential Addresses

    • Social Security #s and/or Social Security Card(s)

    • Current Insurance Cards (if any)​​, including any ancillary coverage such as Dental, Vision, etc.

    • List of your preferred Providers (doctors, dentists, hospitals, clinics, etc)

    • Optional but Recommended: Medication List including dosages, quantity prescribed and type of medicine (pill, tablet, vial, inhaler, etc).  Not all medications are covered under all plans.  However, with your list coverages can be verified prior to selecting a suitable plan.

    • If you are applying for an ACA plan (aka Obamacare) outside of an open enrollment period please have available documentation proving your Qualifying Life Event. This documentation may be emailed (using a scanner or camera if not already in email form), or faxed to me for submission, or submitted via U.S. Mail. 

      • Examples Include (not all may be necessary, check with Ken first):​

        • Letter from Employer showing termination date and last date of employer-sponsored health insurance and those in your family who are losing insurance​

        • Marriage Certificate

        • Proof of new address (utility bill)

        • Proof of Citizenship

        • Birth Certificate of newborn

        • Adoption or Custody Placement documents

        • Termination letter from BadgerCare

        • NOTE:  This is not required for non-ACA plans such as short-term medical, Christian Sharing, Limited Medical, etc. as these alternative plans allow enrollment year-round.

  • To determine eligibility for assistance with your Affordable Care Act plan premium, please bring with you information on

    • Estimated Adjusted Gross Household Income for the year you are seeking coverage. Include income from your spouse even if your spouse is not applying for coverage.  Sources of income may include yearly amounts of:

      • Federal Taxable wages (gross)​

      • Tips

      • Self-Employment Income (net after deductible business expenses)

      • Unemployment Compensation

      • Social Security

      • Social Security Disability

      • Retirement or Pension Income

      • Alimony for divorces finalized before 1/1/2019

      • Capital Gains

      • Investment Income such as taxable Earnings & Interest

      • Rent or royalty income (net)

      • Excluded (untaxed) foreign income

    • NOTE:  If you are new to the program or have had significant changes in income recently, it is recommended you bring documentation supporting your income amounts including copies of statements, pay stubs, profit/loss ledgers for self-employed, etc.

    • NOTE:  If you make contributions to tax-deductible accounts such as Traditional IRA, 401-k, 403-b, HSA, etc., please have those amounts available as these contributions can lower your adjusted gross income and thus increase your eligibility for assistance.

    • NOTE:  Other deductible expenses include Student Loan Interest payments and Alimony payments.

  • If you are a permanent resident or not a U.S. citizen, please have available appropriate documentation supporting your legal residency.​

For Medicare-Eligible applicants:

  • Have your current red/white/blue Medicare Card​​ ready and with you, or at least have your Medicare unique ID# and Effective Dates for Parts A & B.  If you do not know this or have lost your Medicare Card, call Social Security or Medicare to request the relevant information over the phone and have them mail out a new Medicare Card.  NOTE: If your Medicare card has your Social Security # + a single letter as your ID# then you have an OLD card and it needs to be updated and replaced and you should call 1-800-MEDICARE immediately for a new card.

  • Have your Provider Names ready including primary care, specialists and other providers such as Eye Doctors, Dentists, Chiropractors, etc.

  • Have a Medication List ready including dosage and type and how many you fill including your preferred pharmacy name.

  • Bring your Current Insurance Card information including ancillary plans also such as dental, vision, etc.



Bring with you or have ready a method of payment to make your Initial Premium Payment (also known as your Binder Payment).  Most companies accept Automatic Draft out of a Checking or Savings Accounts (bring your routing and account # or a blank check).  Some companies accept MasterCard, Visa and Discover.  It is best to bring both if possible since each insurance company is different.

Medicare items to bring
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