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(888) 244 -1129


Coverage You Can Trust & Partnered With
450 Companies Nationwide

Every Health Self-Enrollment

Contact Details

User  Identification

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Household Income

Additional Information

Is anyone applying for health coverage on this application CURRENTLY incarcerated (detained or jailed)?

To make it easier to determine my eligibility for help paying for health coverage for future years, I agree to allow the Marketplace to use income data, including information from tax returns, for the next 5 years (the maximum number of years allowed).


The Marketplace will send me a notice, let me make any changes, and I can opt-out at any time.

I know that I must tell the program I'll be enrolled in if the information I listed on this application changes.


I know I can make changes in my Marketplace account or by calling (888) 244 -1129


I understand that a change in my information could affect my eligibility for member(s) of my household.

In Addition To Healthcare Which Insurance Would You Like ?

Digital Consent Agreement

Do you authorize Every Health to submit your Application to the Marketplace for your $0 per month health plan?

Do you authorize Every Health to update and make changes to your health plan, in order to keep your policy active or prevent you from losing coverage if needed? 

Do you authorize Every Health to call, text, or email you when we need to update your policy and assist with documents the marketplace may require, such as your income letter?

If the current plan you’re enrolling in today is not available at a $0 cost for the following years, do you authorize Every Health to enroll you in the next best $0 health plan with the same or similar insurance provider that you are enrolling in today?

Do you give consent and Authorize Every Health Group to select and or choose a plan on behalf of the customer enrolling in this application?

By clicking Enroll Now, you consent and request to be enrolled by Every Health Group, and their agents, they may contact you by phone, email, and text/SMS to the home or mobile number(s) you provided, even if you provided the number is on a National, State, or Private, Do Not Call List.


Every Health Group is a healthcare enrollment and service provider all in one so you will have one agency for all your insurance needs.


Coverage You can Trust & Partnered With Over 450 Companies Nationwide

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