General Health Insurance Questions
Why do I need health insurance if I’m healthy?
Even if you're in great shape, health insurance protects you from unexpected medical costs due to accidents or sudden illness. It also gives you access to preventive care like check-ups, screenings, and vaccines—helping you stay healthy long-term.
What does health insurance typically cover?
Most plans cover:
- Doctor visits
- Emergency care
- Hospitalization
- Prescription drugs
- Mental health services
- Maternity and newborn care
- Preventive services
- Pediatric care (including dental and vision)
- Lab tests
- Rehabilitation and therapy
What’s the difference between in-network and out-of-network providers?
In-network providers have agreements with insurance carriers to offer care at discounted rates. Out-of-network providers may cost significantly more, and some plans don’t cover them at all, except in emergencies.
What are premiums, deductibles, copays, and coinsurance?
- Premium: What you pay monthly to keep your plan active
- Deductible: What you pay out-of-pocket before your insurance kicks in (excludes copays)
- Copay: A fixed fee you pay for specific services (like a $25 doctor visit)
- Coinsurance: The percentage you split with your insurance carrier after the deductible (e.g., 80/20 split)
What is an out-of-pocket maximum?
This is the most you’ll ever pay in a year for covered services. After reaching this cap, your insurance pays 100% for in-network covered expenses.
Questions for Self-Employed & 1099 Contractors
Can I get health insurance if I’m self-employed or a 1099 worker?
Absolutely. There are plans specifically designed for independent contractors and small business owners. You don’t need to be part of a company group plan to get affordable, comprehensive coverage.
Are there affordable options for people without employer-sponsored insurance?
Yes. Our team helps you find private plans, Marketplace options, or short-term medical gap coverage that match your health needs and budget, whether you're just starting your business or working multiple short term contract jobs.
What kind of plan should I look for as a 1099 worker?
That depends on your income, medical needs, and lifestyle. You may want:
PPO plans if you want provider flexibility (recommended)- HDHPs if you’re looking to save monthly and pair with an HSA
- Short-term medical plans if you need temporary, budget-friendly coverage
Can I write off my health insurance premiums as a business expense?
If you're self-employed, yes, health insurance premiums may be tax-deductible. Be sure to consult a tax professional for guidance based on your specific situation.
What if I only work part-time or seasonally as a contractor?
You can still get covered. We’ll help you find plans that fit your work schedule and provide protection year-round, even if your income or hours fluctuate.
Understanding Your Coverage
How do I know what’s covered under my plan?
Each plan has a Summary of Benefits and Coverage (SBC) that explains exactly what’s included, like copayments, covered services, exclusions, and limitations. We'll walk you through it.
Are preventive services covered?
Yes. Most plans include free preventive care, like annual check-ups, cancer screenings, vaccinations, and more even if you haven’t met your deductible.
What if I have a pre-existing condition?
Plans that comply with the Affordable Care Act cannot deny coverage or charge you more because of a pre-existing condition.
Is maternity care included?
Yes. ACA-compliant plans cover prenatal, delivery, and postnatal care. We can also help expectant parents find plans that meet their growing family's needs.
Can I get coverage for dental and vision?
Some plans include dental and vision, especially for children. For adults, we can help you bundle separate dental and vision coverage with your health insurance.
Choosing the Right Plan
What are the different types of plans?
- HMO: Lower cost, but you need referrals and must stay in-network
- PPO: More provider flexibility, no referrals needed
- EPO: In-network only but no referrals
- HDHP: Lower monthly cost, higher deductible, compatible with HSA
- Catastrophic: Low-cost plans with high deductibles, best for young, healthy individuals or temporary coverage
How do I know which plan is right for me?
Our team will assess your budget, medical history, and preferences to match you with the best option, whether you want the lowest premium, broad provider access, or robust family coverage.
Can I change my plan later?
Yes. You can change your plan during the Open Enrollment Period (usually in the fall) or if you qualify for a Special Enrollment Period due to life changes like losing coverage, getting married, or having a baby.
Enrollment & Support
Is it hard to sign up for a plan?
Not at all. We make it simple. Our team walks you through every step, from choosing the plan to submitting your application.
Can someone help me compare plans?
Yes. We offer one-on-one support to help you understand the differences between plans, pricing, coverage, and provider networks so you can make the right choice confidently.
What if I don’t understand the policy terms?
That’s what we’re here for. We break down complex insurance language into simple, understandable terms. No jargon, no confusion.
What if I need help using my insurance after I enroll?
We don’t disappear after signup. If you need help with finding a doctor, billing issues, or filing claims, our support team is always ready to help.
Life Situations & Special Needs
Can I get insurance if I’m between jobs or just started freelancing?
Yes. We specialize in gap coverage and affordable short-term plans for those transitioning careers, starting new businesses, or navigating uncertain income periods.
What if I only need temporary coverage?
Short-term plans are a great solution for temporary needs. They cover major medical events and emergencies, often with low monthly premiums.
Is there coverage for my family, too?
Definitely. Whether you're covering a spouse, children, or a full household, we’ll help you find family plans that provide strong coverage at a price you can afford.