Health Insurance
Marketplace plans compared to your doctors, drugs, and budget
We complete Healthcare.gov with you so tax credits, networks, and metal tiers are not a guessing game.
Individual and family health insurance is sold on and off the Affordable Care Act marketplace. The “metal” labels — Bronze, Silver, Gold, Platinum — describe how costs are split, not the quality of care. A Bronze plan is not “worse coverage.” It usually means a lower premium and higher deductibles. Silver is often the smartest starting point if you may qualify for cost-sharing reductions.
Plan designs you will actually see
| Type | Often a fit when | Watch for |
|---|---|---|
| HMO | Lower premiums when you are fine using a defined network and a primary-care doctor as the quarterback. | Out-of-network care is rarely covered except emergencies. Referrals are common. |
| EPO | Network care without always needing a referral, still without out-of-network benefits. | Travel and out-of-area specialists can become expensive. |
| PPO | People who want some out-of-network access or see doctors in several systems. | Higher premiums. Out-of-network bills can still be large. |
| HDHP + HSA | Healthy households that can fund a Health Savings Account and want tax-advantaged savings. | The deductible is real. Confirm HSA eligibility and prescriptions before you switch. |
Tax credits — the part DIY gets wrong
Premium tax credits are based on expected household income and family size. Estimate too low and you may owe the IRS. Estimate too high and you overpay all year. We walk the income questions carefully, including self-employment, Social Security, and changing jobs mid-year.
Cost-sharing reductions (lower deductibles and copays) are generally available only if you pick a Silver plan and your income falls in the eligible range. Choosing Bronze “because it is cheapest” can throw that help away.
What we check before anyone enrolls
- Your doctors and preferred hospitals are in-network.
- Your prescriptions are on the formulary at a tolerable tier.
- Deductible, max out-of-pocket, and premium as a combined number.
- Whether a short-term or off-marketplace plan will work for you.
Short-term medical plans can look inexpensive. They also exclude pre-existing conditions, skip essential health benefits, and can therefore leave you with huge medical bills.
Related: Medicare Advantage and Medicare Supplement if you are 65 or on Medicare due to disability.
Tell us when you are free to talk.
Text or call and we will compare plans against your situation — then send the details for you to review before anyone enrolls.