Individual & Family Health Insurance
Finding health insurance shouldn't mean guessing which plan will actually work when you need it.
We help individuals and families compare ACA Marketplace and private health insurance options based on more than just the monthly premium.
Your doctors, prescriptions, provider network, deductible and out-of-pocket costs will all matter. We'll help you understand the differences and compare your options in plain English.
There isn't one type of health insurance that's right for everyone. Depending on your situation, we may look at ACA Marketplace coverage, private health insurance, or both if we need to split the family up!
ACA Marketplace Health Insurance
“ACA” stands for the Affordable Care Act. ACA Marketplace plans cover essential health benefits and pre-existing conditions.
One of the biggest advantages of Marketplace coverage is the potential for financial assistance. Eligibility for premium tax credits is based on your expected household income, household size and other eligibility factors.
Some households may also qualify for additional savings that can lower deductibles, copays, coinsurance and other out-of-pocket costs.
Private Health Plans
Households that do not qualify for advanced premium tax credits on the ACA may be attracted to private options.
Not all private health plans are ACA-compliant, and eligibility may be based on health history and any ongoing treatments & prescriptions.
Because of this, rates can be cheaper than unsubsidized ACA plans, coverage can be offered on a PPO network, plans can have lower deductibles & out-of-pocket costs, and association plans can offer various other benefits.
Understanding Health Insurance Plan Types
(HMO)
Health Maintenance Organization
HMOs generally require you to choose a primary care physician (PCP) who coordinates your healthcare and provides referrals to specialists within a network of providers. Some HMOs require you to see your PCP before a specialist visit will be covered.
HMOs do not offer out-of-network coverage, and most plans will not cover you out-of-state unless you have a life or limb threatening event.
HMOs typically have lower monthly premiums and out-of-pocket costs but less flexibility in choosing providers.
(PPO)
Preferred Provider Organization
PPOs offer more flexibility in choosing healthcare providers. They offer in-network and out-of-network coverage without needing referrals from a PCP. This includes coverage when you're out of state.
PPOs typically have higher monthly premiums and out-of-pocket costs. You pay for the convenience of healthcare.
(EPO)
Exclusive Provider Organization
EPOs are similar to HMOs but do not require you to see a PCP before a specialist. They do not offer out-of-network coverage, but they tend to have a larger network than an HMO.
EPOs offer lower monthly premiums than PPOs but are typically more expensive than HMOs.
Catastrophic Health Insurance
Catastrophic plans have very high deductibles and are designed to cover worst-case scenarios. People enrolling in these plans typically pay cash for basic/preventative health services and want the lowest monthly premium possible.
To qualify for a catastrophic plan, you must be under 30 years old or qualify for a hardship or affordability exemption.
Short-Term Health Insurance
Short-term plans provide temporary coverage for gaps between other health insurance plans, such as during job transitions.
We also use these plans to keep people insured if they missed open enrollment and don't qualify for a special enrollment period.
Short-term plans typically have limited benefits and are not renewable.
Don't Compare Health Insurance on Premium Alone
When we help clients compare health insurance plans, we look at the bigger picture; including how they expect to use their coverage.
Ready to Browse ACA Marketplace Plans?
If you’d like to explore ACA Marketplace options (including Georgia Access) on your own, you can review available plans and estimated pricing online before speaking with us.
Have questions? Give us a call! We're happy to help.
Shopping for private insurance instead?
Contact us first so we can help you review your options.