Coverage
Health coverage when you do not have an employer plan
If you are self-employed, between jobs, or running a small team, health insurance is one of the largest recurring costs you control the least. There are usually more options than the one you found first.
Most people buying their own health coverage do it once, under time pressure, from whichever site came up first. They end up with a plan that is either more expensive than it needs to be or thinner than they realized.
The honest answer is that no single plan type is best, and which one fits depends mostly on two things: whether you qualify for a subsidy, and whether you would pass medical underwriting.
If your household qualifies for a meaningful premium tax credit, subsidized marketplace coverage is usually very hard to beat and we will say so. The people who benefit most from looking at the alternatives are generally healthy households sitting just above the subsidy threshold and paying full price.
What we compare
- ACA plans — on and off exchange
- Guaranteed issue with no medical underwriting, essential health benefits, and premium tax credits for households that qualify on income. If you qualify for a meaningful subsidy, this is almost always the right answer and we will tell you so plainly.
- Short term medical
- Temporary coverage, medically underwritten, usually far cheaper than unsubsidized ACA premiums. It can decline you for health history, commonly excludes pre-existing conditions, and is not major medical. Genuinely useful for a healthy person bridging a gap; wrong for most other situations.
- Multi-year underwritten medical
- Longer-duration underwritten plans that behave more like traditional major medical and can run up to around three years depending on state. Available only to people who pass underwriting, and still not ACA coverage.
- Fixed indemnity and limited benefit
- Plans that pay set amounts per service rather than a share of the actual bill. These have a place as a supplement. They are not a health plan, and the gap between a benefit schedule and a real hospital invoice can be very large.
- Supplemental and ancillary
- Accident, hospital indemnity, critical illness, dental and vision. Available year-round, and they sit alongside whatever coverage you already have rather than replacing it.
Not everything on this list is major medical coverage, and we will always say which category a plan falls into before anything else about it.
What actually determines your cost
- Household income relative to subsidy thresholds — the single biggest factor for most families
- Where you live, down to the county rating area
- Ages of everyone being covered
- Whether you or your family use tobacco
- Metal tier and how the plan splits deductible, copays and out-of-pocket maximum
- Whether your doctors and prescriptions are in network and on formulary
We check your specific doctors and prescriptions against a plan before recommending it. That step is skipped more often than it should be.
Things worth knowing before you shop
- Open enrollment has deadlines; outside of it you generally need a qualifying life event such as losing coverage, moving, marriage or a birth
- Some non-ACA products are not major medical coverage and may exclude pre-existing conditions or cap benefits — read what a plan does not cover, not only what it does
- The lowest premium and the lowest total annual cost are frequently different plans
- If you are self-employed, health insurance premiums may be deductible; confirm treatment with your tax professional
Questions
Common questions
Straight answers, including the ones that make the strategy sound less appealing.
Do you charge for help finding coverage?
I make too much for a subsidy. What are my options?
Should I drop my ACA plan for something cheaper?
Can I get coverage outside of open enrollment?
Can you cover my small team?
Next step
See what you actually qualify for
Send the basics and we will come back with the options available in your area, including what each plan does not cover.
Never send account numbers, Social Security numbers or policy numbers through a web form.
Request a private health insurance quote
Share the basics and we will come back with the options available to you. Do not include medical history here — that is handled through the carrier's secure application.
Related strategies
Supplemental Coverage
Accident, hospital, critical illness and dental cover that pays cash into the gap a high deductible leaves.
Life Insurance
Term, permanent and hybrid coverage, sized and structured around the plan rather than sold in isolation.
Tax Advantaged Retirement
Diversify not just what you own, but how it will be taxed when you eventually use it.
Important disclosures. Health insurance plan availability, benefits, provider networks, formularies, premiums and eligibility vary by state, county, carrier and individual circumstances. Subsidy eligibility is determined by household income and family size under applicable federal rules. Some products described are not major medical coverage and do not satisfy all requirements of the Affordable Care Act. Plan documents govern in all cases. This page is educational and is not a recommendation of any specific plan.
Next step
Fifteen minutes, and you will know where you stand.
A review is a short conversation about the coverage and savings you already have. We look at what you pay, what it covers, and whether there is a better fit available where you live. No cost, no obligation, and no pitch if nothing needs changing.