Who it's for
- People without job-based coverage, including early retirees under 65
- Part-time, contract, and gig workers
- Anyone between jobs or whose employer coverage is ending
- People who want to compare their current plan against other options
What it covers
Plans that meet Affordable Care Act standards cover the essential health benefits, including:
- Preventive care, doctor visits, and outpatient services
- Emergency services and hospitalization
- Prescription drugs
- Maternity and newborn care
- Mental health and substance use services
- Lab work, rehabilitation services, and pediatric services, including children's dental and vision
Key things to know
On-Marketplace vs. off-Marketplace
ACA-compliant plans can be bought through the Health Insurance Marketplace (where income-based savings are available) or directly from a carrier. Hollen can show you both.
Metal levels describe cost sharing, not quality
Bronze, Silver, Gold, and Platinum plans split costs differently. Lower-premium plans usually have higher out-of-pocket costs when you get care, and vice versa.
Network type changes how you get care
HMOs and EPOs usually require you to use in-network providers. PPOs typically offer some out-of-network coverage at a higher cost. Always check your doctors and prescriptions.
Know your key cost terms
Premium (what you pay each month), deductible (what you pay before the plan starts sharing costs for many services), copays and coinsurance, and the out-of-pocket maximum.
Timing matters
You can generally enroll during the annual Open Enrollment Period, or outside it if you have a qualifying life event such as losing other coverage, moving, marriage, or having a baby.
Frequently asked questions
Can I be turned down because of a pre-existing condition?
ACA-compliant individual plans can't deny coverage or charge you more because of a pre-existing condition. Some other types of plans, like short-term medical, can, so it's important to know what you're buying.
What's the difference between 'private' and 'Marketplace' insurance?
Marketplace plans are private insurance plans offered by private carriers. The Marketplace is simply where you can compare them and apply for income-based savings.
Can I keep my doctor?
Possibly. It depends on whether your doctor is in the plan's network. Hollen can help you check specific doctors and prescriptions before you choose.
This page is general educational information, not a guarantee of coverage, eligibility, or cost. Benefits, availability, and rules vary by plan, carrier, and state. Contact Hollen for details on specific plans.