COVERAGE
THAT TRAINS
WITH YOU.

No. ACA plans cannot deny you, charge you more, or exclude care because of pre-existing conditions — including prior orthopedic surgeries, soft-tissue tears, or chronic athletic injuries. Your prior ACL, labrum, or stress fracture is fully covered.

Send us your current provider list during intake. We cross-check every recommendation against the ortho group, sports medicine clinic, PT studio, and imaging center you actually use — before you enroll, not after.

All ACA plans cover diagnostic imaging when medically necessary, but copays, coinsurance, and prior-authorization rules vary. Gold and Silver-CSR plans typically have the lowest out-of-pocket for imaging — important for athletes who get scanned more than the average enrollee.

ACA marketplace plans cannot exclude care because of sport. BJJ, MMA, boxing, and wrestling injuries are covered like any other injury. We pick plans with strong orthopedic and dental coverage since combat athletes use both.

Mental health is an Essential Health Benefit under the ACA — therapy visits with licensed providers are covered. Sports-performance coaching specifically isn't a medical benefit, but we route athletes to plans with strong mental health networks that include performance-trained therapists.

Every ACA plan has an out-of-pocket maximum — the most you'll pay in a calendar year for in-network care. 2025 federal cap: $9,200 individual / $18,400 family. Once you hit it, the plan pays 100% of covered in-network costs. Critical math for athletes facing surgery + rehab.

Yes, if your modified adjusted gross income (MAGI) falls within subsidy eligibility ranges. Semi-pro athletes are often in the subsidy sweet spot. Your advisor calculates exact subsidy at intake based on projected annual income.

Health insurance covers the medical care. Short-term and long-term disability insurance covers lost income if injury keeps you from working. We can pair an ACA medical plan with a supplemental disability product — ask your advisor at intake.