What types of insurance do you help with?

We help with health insurance, dental insurance, vision insurance, life insurance, and business insurance for individuals, families, and self-employed professionals.

How much does it cost to get insurance quotes?

Our quotes are completely free! We work with insurance companies to help you find the best coverage at the most competitive rates without charging you anything.

Which states do you serve?

We serve clients across 30+ states nationwide. Check our map or contact us to see if we can help in your area.

Can you help me find ACA health insurance?

Yes! We specialize in helping clients navigate ACA (Affordable Care Act) plans and find coverage that fits their budget and healthcare needs.

How much does health insurance cost?

Costs vary based on age, location, coverage level, and family size. Individual plans typically range $150-$500+ monthly. Family plans range $400-$1,200+ monthly. Many qualify for subsidies reducing costs.

What is the difference between HMO and PPO?

HMO plans require a primary care doctor and referrals, offer lower premiums but less flexibility. PPO plans allow any doctor without referrals, offer more flexibility but higher premiums and lower out-of-pocket costs with network providers.

Will insurance cover my pre-existing condition?

Yes. Under the ACA, insurance companies cannot deny coverage, charge more, or exclude treatment based on pre-existing conditions. All ACA-compliant plans cover pre-existing conditions with no waiting periods.

When can I enroll in health insurance?

Open Enrollment Period runs November 1 to January 15 annually. Special Enrollment Periods are available year-round after qualifying life events like marriage, birth, or loss of previous coverage.

What health insurance options are available?

Health insurance options include HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), HDHP (High Deductible Health Plan), Point of Service (POS), and Exclusive Provider Organization (EPO) plans. Each offers different levels of flexibility and cost. ACA (Affordable Care Act) plans are available for individuals and families, while self-employed individuals can choose from self-employed health insurance options. Small businesses can offer group health insurance plans to employees. The best option depends on your healthcare needs, budget, and coverage preferences.

How do I choose between HMO, PPO, and HDHP plans?

HMO plans have lower premiums but require you to use in-network doctors and get referrals for specialists. PPO plans offer more flexibility to see any doctor but have higher premiums. HDHP plans have low premiums with high deductibles but allow you to use Health Savings Accounts (HSA). Choose HMO if you want lower costs and don't mind limitations, PPO if you value flexibility, and HDHP if you're healthy and want to save for healthcare long-term. We help you compare these options based on your specific situation.

What is a deductible and how does it work?

A deductible is the amount you must pay out of your own pocket before your insurance starts covering your healthcare costs. For example, if you have a $1,500 deductible, you pay the first $1,500 of healthcare expenses yourself, then your insurance covers the rest (based on your plan). Higher deductibles mean lower monthly premiums, while lower deductibles mean higher monthly premiums. Preventive care like annual checkups is often covered even before you meet your deductible.

What is a copay versus coinsurance?

A copay is a fixed amount you pay for a specific service (like $20 for a doctor visit). Coinsurance is a percentage of the cost you pay after meeting your deductible (like 20% of surgery costs). Most insurance plans use both: you pay a copay for routine visits and coinsurance for major procedures. Your insurance company pays the remaining percentage. Understanding your copay and coinsurance helps you predict healthcare costs.

What does "out-of-pocket maximum" mean?

The out-of-pocket maximum is the most you'll have to pay in a calendar year for covered healthcare services. Once you reach this limit, your insurance covers 100% of remaining covered healthcare costs for the rest of that year. This includes deductibles, copays, and coinsurance. The 2024 out-of-pocket maximum for individual coverage is $9,450 and $18,900 for family coverage. This protects you from catastrophically high healthcare bills.

What is an in-network provider?

An in-network provider is a doctor, hospital, or healthcare facility that has an agreement with your insurance company to provide services at negotiated rates. Using in-network providers costs you less because they've agreed to lower rates. Out-of-network providers don't have these agreements, so you pay more. Most plans require you to use in-network providers or pay a much higher percentage of the cost. You can check your plan's provider network on the insurance company website.

What is the Affordable Care Act (ACA)?

The Affordable Care Act (ACA), also called Obamacare, is healthcare legislation requiring all Americans to have insurance. ACA plans are available through healthcare.gov and offer comprehensive coverage including preventive care, emergency services, and prescription drugs. They provide coverage regardless of pre-existing conditions. Tax credits and subsidies lower costs for eligible individuals based on income. Open enrollment for ACA plans runs November 1 - January 15 each year, though special enrollment periods may apply for qualifying events.

How much does health insurance cost for a self-employed person?

Health insurance costs for self-employed individuals vary widely from $200-$1,000+ per month depending on age, location, health status, and plan choice. Self-employed individuals can deduct 100% of health insurance premiums as a business expense, reducing taxable income. Options include ACA plans (often eligible for tax credits), short-term health insurance, health sharing ministries, and spousal plans. On average, self-employed people pay 20-50% less than traditional health insurance through ACA plans due to available subsidies.

What health insurance options do I have between jobs?

Between jobs, you have several options: COBRA continues your employer coverage for up to 18 months but costs 100% plus admin fees. Marketplace/ACA plans offer new coverage with potential tax credits. Short-term health insurance provides temporary coverage while you transition. Medicaid may be available depending on income. Medicare may apply if eligible. A qualifying life event (job loss) triggers special enrollment, allowing you to enroll in any marketplace plan outside open enrollment. We help you find the most affordable option for your situation.

What is dental insurance and is it included in health plans?

Dental insurance covers preventive (cleanings, X-rays), basic (fillings, extractions), and major (crowns, root canals) dental work. Most health insurance plans do NOT include dental coverage, so you need a separate dental insurance policy. Dental plans typically cost $10-50/month for individuals. Preventive care is often fully covered, while basic and major services require copays or coinsurance. Dental plans usually have annual maximums (typically $1,000-2,000). Standalone dental insurance is more affordable than paying out-of-pocket for dental work.

Do I need vision insurance?

Vision insurance is a separate policy, not included in health insurance, that covers eye exams, glasses, and contact lenses. It costs $10-25/month and typically covers 1-2 eye exams yearly with benefits for frames, lenses, and contacts. If you wear glasses or contacts, vision insurance saves money. Most plans have low copays for exams ($10) and allowances for frames ($100-200) and contacts ($100-150). Vision insurance is optional unless you need regular eye care or corrections. We help determine if it's worth it for your situation.

What is the difference between health insurance and life insurance?

Health insurance covers your medical and healthcare expenses while you're alive. Life insurance pays a death benefit to your beneficiaries when you pass away. Health insurance is about protecting your current health; life insurance is about protecting your family's financial future. Most employers offer health insurance, but life insurance is usually optional or available at a separate cost. You typically need both: health insurance for medical coverage and life insurance (term or whole life) to protect dependents from financial hardship.

How do you handle the health insurance enrollment process?

We simplify the health insurance enrollment process. We help you compare plans side-by-side, answer all your questions, and guide you through application and enrollment. We work with healthcare.gov for ACA plans, directly with insurance companies for private plans, and handle all paperwork. We verify eligibility, apply tax credits and subsidies you qualify for, explain plan details in plain language, and ensure you're enrolled before coverage starts. After enrollment, we help manage claims, answer coverage questions, and assist with any changes during the year.

What states do you provide health insurance services in?

We serve clients in 30+ states nationwide, helping with health, dental, vision, life, and business insurance. Services include health insurance guidance for individuals, families, and self-employed people; small business health insurance; and Medicare navigation. While we serve multiple states, available plans vary by location and individual circumstances. We can provide a free consultation to discuss available options in your state and find the best coverage for your needs. Contact us to confirm services in your area.

How much does a consultation cost?

All consultations are completely FREE. We don't charge for initial consultations, plan comparisons, enrollment assistance, or claims support. We earn our income through commissions paid by insurance companies when you enroll in plans we recommend - not from you. This means our interests are aligned with yours: we only recommend plans we believe are the best value. You get expert guidance at zero cost, with no obligation to enroll. Schedule a free consultation to discuss your health insurance options.

That Health Insurance Guy

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