Health Insurance
Navigate the marketplace, Medicare, and private plans with an advisor on your side.
What is health insurance?
Health insurance is the coverage people find most confusing — networks, deductibles, out-of-pocket maximums, subsidies, enrollment windows. Choosing wrong can mean thousands in unexpected costs or discovering your doctor is out of network when you need them most.
We help individuals, families, and the self-employed compare plans clearly: ACA marketplace plans (with premium tax credits you may not realize you qualify for), off-exchange options, and supplemental coverage like dental, vision, and accident plans. Our guidance costs you nothing — we're paid by the carriers, and your premium is identical whether you enroll through us or on your own. The difference is having someone to call when a claim goes sideways.
What it covers
- Preventive care — annual checkups, screenings, and immunizations at no cost on ACA-compliant plans
- Doctor visits, specialist care, and urgent care
- Emergency services and hospitalization
- Prescription drugs
- Mental health and substance-use treatment
- Maternity, newborn, and pediatric care — including dental and vision for children
What it doesn't cover
- Out-of-network care, except true emergencies, on HMO and EPO plans
- Adult dental and vision (available as inexpensive standalone policies)
- Most cosmetic procedures
- Care received before coverage starts — enrollment windows matter
Coverage components explained
1Premium
Your monthly cost to keep the plan. On marketplace plans, premium tax credits can reduce this substantially based on household income — many families qualify and don't know it.
2Deductible
What you pay for care before the plan starts sharing costs. Plans with low premiums carry high deductibles and vice versa — the right balance depends on how much care you expect to use.
3Copays & Coinsurance
Your share of each service after (or sometimes before) the deductible — a flat copay per visit or a percentage of the bill.
4Out-of-Pocket Maximum
The most you can pay for covered, in-network care in a year. This is the number that matters in a bad year — it's your true worst-case exposure.
5Network (HMO / PPO / EPO)
Which doctors and hospitals the plan covers. HMOs cost less but restrict you to network providers with referrals; PPOs cost more but offer flexibility. We check that your doctors and medications are covered before you enroll.
6Metal Tiers
Bronze, Silver, Gold, and Platinum reflect cost-sharing, not quality. Silver plans unlock extra cost-sharing reductions for income-qualified households — sometimes making Silver better than Gold for less money.
When you need health coverage
- You're self-employed or your employer doesn't offer coverage
- You're losing employer coverage — job change, layoff, or COBRA decision (loss of coverage opens a special enrollment period)
- You're turning 26 and aging off a parent's plan
- You're approaching 65 and need to navigate Medicare enrollment correctly (late-enrollment penalties are permanent)
- Your income changed — you may now qualify for subsidies that make better coverage affordable
Frequently asked questions
When can I enroll in health insurance?
Open enrollment runs roughly November 1 – January 15 in most states. Outside that window, you need a qualifying life event — losing other coverage, moving, marriage, a new child — which opens a 60-day special enrollment period. If you think you've missed your window, call us; there are often more options than people realize.
Does using an agent cost more than enrolling myself?
No. Premiums are set by regulation and are identical with or without an agent. The carrier pays us. What you gain is plan-selection guidance, a network check against your actual doctors and prescriptions, and an advocate when claims or billing go wrong.
What's the real difference between Bronze and Gold plans?
How costs are split — not the quality of care. Bronze means low premium, high deductible: good if you're healthy and want catastrophic protection. Gold means higher premium, lower out-of-pocket costs: good if you use regular care or take ongoing medications. We'll model your expected usage both ways.
I'm self-employed. What are my options?
Marketplace plans with premium tax credits (your subsidy is based on net self-employment income), and your premiums are generally tax-deductible. Depending on your state and situation, association or group-of-one options may also exist. This is one of the most common situations we handle.
Do you help with Medicare?
Yes — Medicare Supplement (Medigap) and related guidance for those approaching 65. Initial enrollment decisions have permanent consequences (Medigap underwriting rights, Part B/D penalties), so talk to us a few months before your 65th birthday.
Let's find the right health coverage for you
Answer a few questions and a licensed advisor will compare quotes across our carrier lineup — usually back to you within one business day.