$0 Premium Healthcare For Those Who Qualify - Complete The Form Below

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4 Out of 5

Of Our Customers Qualify for A $0 premium Health

Insurance Policy

4 Out of 5 Applicants Qualify for A $0 premium Health

Insurance Policy

Apply online in minutes!

Do you feel insecure about your healthcare situation?
Unsure if you qualify for a $0 health insurance plan?

We can help you to find Marketplace health insurance as part of the Affordable Care Act

“I am absolutely ecstatic and pleased with my experience with Boost Health. My agent got me a plan better than I ever had expected!”

Allison Q, Los Angeles, CA

Carriers We Represent

... And Many More!

How it works

Eligibility for a complimentary health plan is based on household income.

If your income falls within the blue bracket, you qualify.

Don't wait, submit the form below!

Family Size	100%	150%	200%	400%
1	$14,580	$21,870	$29,160	$58,320
2	$19,720	$29,580	$39,440	$78,880
3	$24,860	$37,290	$49,720	$99,440
4	$30,000	$45,000	$60,000	$120,000
5	$35,140	$52,710	$70,280	$140,560

Note: Exact income levels may vary by state.

See If You Qualify!

Name of Your Employer *

Do you have insurance through your employer, Medicare or VA? *

First Name *

Last Name *

Street Address *

City *

State *

Postal code *

Phone *

Email *

Main Applicant Birth Date (D.O.B.) *

Spouse Name

Spouse Date of Birth

How many people need coverage?

Please Be Accurate - Income Will Be Verified By Healthcare.gov

Expected Income Per Month *

$

*

You attest that your estimated income for 2023 will be at least the Federal Poverty Limit for your state and household requirements . You agree to notify us as soon as you become aware of any changes to expected income per month that you provided above. Failure to notify us of any changes may result in your eligibility being affected.

*

In some cases, it may be necessary to verify your income. If income verification is required in order to complete your enrollment, do you authorize Boost Health Insurance Agency to submit an income attestation letter on your behalf with the information that you have provided?

Consent to Enrollment; Verification of Information

By Checking This Box I Hereby Provide Consent and authorization To Boost Health Insurance Agency, LLC. To Enroll Me And/Or My Family In A Health Insurance Plan Through The ACA Marketplace. If I Already Have A Plan, I Request That Boost Health Insurance Agency, LLC. And Its Agents Become My Agent Of Record And Switch Me To A Better Plan If One Is Available. This consent will remain in effect unless and until rescinded by you in writing by emailing help@healthinsurancesolutions.org.

Acknowledgements

*

By checking this box I provide my express consent to Boost Health Insurance Agency, LLC. and grant Boost Health Insurance Agency, LLC. and/or its agents a limited power of attorney to enroll me in a health insurance plan and to automatically enroll me in a plan at renewal.

I hereby signify my agreement with the foregoing by signing below

Application is complete. Please hit submit button below.

TextApplication Complete. Please click submit below.

Please contact us at help@healthinsurancesolutions.org if you need any further assistance.

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(License Number: 0L14409)

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