No jargon, no sales pitch — just the terms and concepts you need to make sense of your options before you ever talk to an advisor.
Tap any term to expand it. These are general definitions — always confirm specific plan features against your actual policy documents.
General market information, not a promise about any specific plan — always verify features against the actual policy.
These are two different, both legitimate, pricing mechanisms. Community rating (used by ACA marketplace plans) charges everyone in a pool the same rate regardless of health. Medical underwriting (used by private plans) prices based on individual health profile. Neither is a scam — it's about which mechanism fits your situation.
Some private plans on the market offer low-to-$0 deductible structures alongside broader networks. This is a real plan-shape option worth asking about — but it's plan-specific, not universal, so confirm the exact deductible and out-of-pocket max on any option you're considering.
Many private plans on the market now include telehealth access as a standard feature, letting you connect with a provider remotely for many routine needs. Availability and scope vary by plan, so confirm what's included before assuming.
Health insurance premiums are generally deductible from federal taxable income for self-employed individuals — a standard federal provision that can apply whether you're on a private plan or an ACA marketplace plan. This is general tax information; talk to a tax professional about your specific situation.
Deeper dives for people whose work doesn't look like a 9-to-5 in one zip code.
Why agency benefits fall short between contracts — and how a private PPO plan closes the gap.
Read the GuideWhy local networks break down hundreds of miles from home — and what to look for instead.
Read the GuideComparing private PPO plans against ACA marketplace subsidies when your income isn't a fixed number.
Read the GuideWhat happens when your employer's network is built around an office you never visit.
Read the GuideShort, sourced explainers on the changes that actually affect what you pay and when you can enroll.
Only 14% of marketplace plans are PPOs. Where broad networks still exist.
The marketplace charges you for everyone else’s health. Private plans charge you for yours.
The caps on repaying excess premium tax credits were repealed for tax year 2026.
It does not always mean waiting a year. Qualifying events and year-round options.
Usually the expensive option — with one specific exception worth knowing.
If you were auto-enrolled, an algorithm picked your plan. Three things to check.
There is a discount that only exists on Silver. Miss it and the cheap plan costs more.
When coverage ends depends on the plan type — the two answers are months apart.
Being in network with a carrier is not the same as being in network with your plan.
The coverage gap is real in ten states — but some who assume they are in it are not.
Each state handles the ACA marketplace and Medicaid a little differently — here's how that shapes your options.
Federal marketplace, no Medicaid expansion — a real coverage gap for low earners.
The highest uninsured rate in the country, and the largest coverage gap of any state.
Left HealthCare.gov for its own exchange, Georgia Access, in 2025.
Variable income, and the subsidy repayment rules that changed for 2026.
Agency coverage ends with the contract. Covering the gap between assignments.
Runs its own state-based exchange with a longer open enrollment window.
761,457 enrollees, six insurers, and Medicaid expanded in December 2023.
Eleven carriers competing, and still hard to find a broad network.
Own state-based exchange, Medicaid expanded since 2014, no coverage gap.
A DOT physical is not health insurance. Why network breadth beats premium.