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Regardless of how you enroll, insurance premiums are state regulated. Using an agent will not have any added costs or fees. The difference is the level of service you receive. An agent offers more guidance when choosing a plan and provides ongoing support after you enroll in health plan.

When comparing plans, there are a few deciding factors that I look at:

• What is my premium-this is amount you will each month to have coverage. The lower the premium, the more money you are expected to pay for out-of-pocket costs.

• Provider network-the plan may sound great, but if none of your preferred providers are contracted with the network, you will have to switch providers or be expected to pay out-of-pocket costs. Also, does the network travel with you or are you limited to your local area?

• Deductible- is the amount you must pay out-of-pocket before your insurance begins covering services. Once your deductible is met, your insurance will pay a percentage of covered costs, and you’ll be responsible for the remaining portion.

Example:

• Annual deductible is already met.

• You see your primary care doctor for strep throat.

• Visit cost: $150.

• Insurance covers 80% ($120).

• You pay: $30.

Remember: Deductibles reset every year, so this process starts over with your new plan year.

• Out-of-Pocket Maximum-this is most amount of money you will have to pay in a year. Once you reach this amount, the insurance will may 100% for all services.

These factors will help with the process of elimination. Need help navigating plans? I will help guide you to a plan that fits your needs and budget.

If you are signing up for a Marketplace plan, there is a strict period of time you are able to sign up or switch to one of these plans, if eligible. The Open Enrollment Period for 2025-2026 is Nov 1st - Jan 15th. The only way you would be able to sign up for a coverage outside of this time frame, would be for a special life event, like marriage, job change or new baby.

Private health insurance does not follow the same Open Enrollment Period. Majority of private plans allow you to sign up year-round.

Yes — depending on the type of coverage you need, there are options available year-round. I often work with clients who fall into what’s called the “invisible market,” such as gig workers, early retirees, individuals coming off COBRA, students, and small business owners.

Experiencing any life events such as moving, marriage, loss of employment may also allow you to enroll in a plan outside of Open Enrollment.

It’s important to have a provider you feel comfortable with — someone who listens, answers questions, and explains things in a way you understand.

When reviewing your plan options, I’ll go through your current providers, specialists, and hospitals to confirm whether they are in-network. If they aren’t, I’ll make sure you know right away.

Once you’ve chosen a plan that fits, I always recommend giving your provider’s office a quick call to double-check they are in-network. The provider network list is usually up to date but a few minutes on the phone can save you from costly surprises later.