Health Insurance That Fits Your Life

HMO plans usually have lower premiums but require you to choose a primary care doctor and get referrals for specialists. You must stay in-network for coverage. PPO plans cost more but give you flexibility to see any doctor and don't require referrals. EPO plans fall somewhere in between-no referrals needed but you must stay in-network except for emergencies. Each has trade-offs between cost and flexibility.

Your deductible is what you pay for covered services before insurance starts sharing costs. Once you hit your deductible, you typically pay copays or coinsurance. The out-of-pocket maximum is the most you'll pay in a year-after you reach it, insurance covers everything else at one hundred percent. Understanding these numbers helps you budget for healthcare costs.

That depends on whether your doctor is in the plan's network. Before choosing a plan, check if your preferred doctors and hospitals participate. With HMO and EPO plans, staying in-network is usually required for coverage. PPO plans let you go out of network but you'll pay more. We can help you verify your doctors are covered before you enroll.

There's an annual open enrollment period, usually in the fall, when anyone can sign up for coverage. Outside that window, you typically need a qualifying life event like losing job-based coverage, getting married, having a baby, or moving to a new area. Once you have a qualifying event, you have a limited time to enroll-usually sixty days. Don't wait too long or you'll miss your chance.

You might qualify for premium tax credits or cost-sharing reductions based on your income and household size. These subsidies can dramatically lower what you pay each month. Some people end up paying very little for coverage. We'll help you figure out if you qualify and how much assistance you might receive. Even if your income fluctuates, there are options to make coverage more affordable.