Let's Make This Simple

Ways to get covered, explained plainly

There's more than one road to health coverage. Here's a friendly breakdown of the three main routes, plus answers to the questions we hear most.

ACA / Obamacare Plans

The public marketplace has offered plans since 2014, with subsidies for those below the federal poverty line and guaranteed coverage even with pre-existing conditions.

Best if: you qualify for income-based subsidies or manage a major pre-existing condition.

Private Market Plans

Private plans use medical underwriting, which means more selective enrollment — but that selectivity often means lower rates and stronger benefits for those who qualify.

Best if: you're in good health and don't qualify for much government assistance.

Employer Plans

Employers typically cover about half of your premium — but usually nothing toward dependents, which can make family add-ons surprisingly expensive.

Worth checking: pricing an individual plan against your employer's family add-on could save you hundreds a month.

Common Questions

Frequently asked questions

Your deductible is what you pay out of pocket before your plan benefits kick in. The right number for you really comes down to how often you typically use healthcare during the year.

Your copay is a flat amount you pay for things like doctor visits, prescriptions, urgent care, or labs. Coinsurance is a percentage of costs you're responsible for once you've met your deductible.

Your OOPM is the absolute most you'd pay for covered care in a plan year. It depends on your coverage level, and it should be set at an amount you could realistically handle if something major happened.

A PPO lets you see any physician, in or out of network, without a referral. An HMO limits you to a specific group of providers and requires referrals from a primary care physician to see specialists.

Yes — there are no contracts on public or private health insurance plans, so you're free to cancel whenever you need to. (Employer coverage is the one exception.)

You don't need to be in elite shape — just relatively healthy. We'll always look at your individual situation, but if you don't have a major condition like cancer, a heart attack, stroke, or diabetes, a private plan could be a great fit.

That rule only applies to Marketplace/ACA plans and employer coverage. Private plans are available year-round, so there's no waiting for a specific window.

Not at all — we also write Dental and Vision policies. And for Life Insurance or investment products, we have trusted referral partners we're always happy to connect you with.

It's usually much less expensive than people expect. Since rates are based on your health rather than your income, you'll often see lower prices and better benefits if you qualify — most clients save somewhere between $1,200 and $3,600 a year.

Still have questions? Let's just talk it through.

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