2025 Enrollments and Renewals

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Who needs health coverage?

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Your Information

First Name*

Last Name*

Date of birth

Gender*

Uses Tobacco?*

Affordable Medical Coverage Available? Yes No

Effective Date

Household Information

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Email Address*

Annual Household Income*

Household Size*

Your Subsidy: $0 /month

Cost Sharing Reduction: N/A

	Name		Tax Credit Eligibility
			May be eligible for a Premium Subsidy

Estimated Results: Your subsidy is only an estimate and not an actual determination of premium subsidy and or Medicaid and CHIP eligibility. Healthcare.gov and your state's Medicaid and CHIP programs make all determinations of eligibility; the actual results may vary from this estimate.

Your Estimated Subsidy is: $0.00

Total available plans: 0