Health insurance, minus the jargon.
Short, honest guides so you can make a smart call, whether you work with me or not. No sales pitch, just plain English.
Updated
Here's the honest problem with health insurance: it's sold in a language nobody taught you. Premiums, deductibles, networks, coinsurance. The words all sound official, so people nod along, pick a plan off the first number they see, and find out in March what they actually bought. I've sat across from too many smart people who were paying for the wrong coverage simply because nobody ever explained the vocabulary.
That's what this section of the site is for. Each guide takes one decision you'll actually face, strips out the jargon, and shows you the real tradeoff underneath it. They're written the same way I talk to my own clients: plain English, real numbers, and no pretending one answer fits everyone. Read them in any order, though if you're brand new to buying your own coverage, start with premium vs. deductible, then move to plan types.
Five words that unlock everything else
Almost every confusing sentence in a health plan is built from a handful of terms. Get these down and the rest of the fine print starts reading like normal English.
Your monthly bill, what you pay just to keep the plan active, whether you use it or not. It's the first number you see, and the most misleading one to shop on alone.
What you pay out of your own pocket for care before the plan starts sharing costs. A low premium usually hides a high one of these.
The doctors and hospitals that have agreed to your plan's pricing. Every plan type (HMO, PPO, EPO, POS) is really just a different set of rules about this list.
Your share after the plan kicks in: either a flat fee per visit (copay) or a percentage of the bill (coinsurance, often 20%).
Your safety net. The most you can pay for covered, in-network care in a year. After this, the plan pays 100%. In a bad year, this number matters more than any other.
The yearly window when anyone can sign up or switch plans. Outside it, you need a qualifying life event (a move, a marriage, losing other coverage) to make a change.
The rest of the vocabulary
The five above carry most of the weight. These are the ones that turn up next, usually in the middle of a sentence you were hoping to skim. Nothing here is a sales pitch. It is the plain meaning, so you can read your own plan documents without a translator.
The government-run site where you shop for ACA plans and find out whether you qualify for a subsidy. Florida uses HealthCare.gov. Some states run their own.
A plan you buy straight from an insurer or through a broker instead of through the Marketplace. Some are the same ACA-compliant coverage sold outside the exchange. Others are a different product with different rules about what they cover. Always ask which one you are looking at.
A subsidy that lowers your monthly premium, based on the income you expect for the year. It applies only to Marketplace plans. If your income lands somewhere else, it gets squared up at tax time.
A window outside open enrollment when you are allowed to enroll. A qualifying life event opens it. Most of them run 60 days.
The thing that opens a special enrollment period. Losing other coverage, moving, marriage, divorce, a birth or an adoption.
Bronze, Silver, Gold, Platinum. It describes how you and the plan split costs, not the quality of the care. Bronze means a lower premium and more out of pocket when you use it.
Extra help that lowers your deductible and your out-of-pocket costs. It attaches only to Silver plans, and only if your income qualifies.
The categories every ACA-compliant plan has to cover. Hospital stays, prescriptions, maternity, mental health and preventive care among them.
A health issue you already have when coverage starts. ACA-compliant plans cannot turn you down or charge you more for one. Many private-market plans ask about it on the application and base approval and price on the answers.
When an insurer asks health questions up front and bases approval and price on your answers. ACA plans do not do this. Many private-market plans do.
Coverage you cannot be denied for health reasons. Every ACA-compliant plan works this way.
The plan's list of covered prescriptions, sorted into tiers that cost you different amounts. Check yours before you enroll, not after.
When the plan has to approve a treatment or a drug before it will pay for it. Your doctor's office starts the request.
Permission from your primary doctor to see a specialist. HMOs usually require one. PPOs usually do not.
In-network providers agreed to your plan's pricing. Out-of-network providers did not, and the difference usually lands on you.
The statement your plan sends after a claim. It is not a bill. It shows what was charged, what the plan paid, and what is left for you.
A high-deductible health plan paired with a health savings account. The account is yours, the balance rolls over, and the contributions are tax-advantaged. Not every high-deductible plan qualifies.
The day your coverage actually starts. Not the day you enrolled, and not the day you paid.
The time you get to catch up on a missed premium before the plan cancels. How long you have depends on whether you receive a subsidy.
The income benchmark subsidies are measured against. Eligibility is usually described as a percentage of it.
Modified adjusted gross income. The income figure the Marketplace uses to work out your subsidy. It is not the same as your take-home pay.
Screenings and routine checkups that ACA-compliant plans cover at no cost to you when you stay in network.
The guides
Thirteen are live now, with more on the way. If your question is less "how does insurance work" and more "what should I buy," that's a different conversation, and the coverage page shows the kinds of plans I work with.
Open enrollment 2027
Enrollment opens November 1. The closing date is stuck in a federal appeal, the subsidy math changed underneath everyone, and one date makes all of that irrelevant.
Read the open enrollment guide →Aging off a parent's plan
Two different clocks decide when you lose the family plan, and a 60-day window decides what happens next. Every option you have, in plain English.
Read the turning-26 guide →Premium vs. deductible
The two terms people mix up most, and getting them backwards can cost you real money. Here's what each one means and how they trade off.
Read the premium vs. deductible guide →HMO vs. PPO vs. EPO vs. POS
Four sets of initials, one real question: how much freedom do you want, and what will you pay for it? The plain-English breakdown, with a cheat-sheet table.
Read the plan types guide →Private plans vs. the marketplace
There are two doors to buying your own coverage, and most people only know about one. Subsidies, underwriting, networks, and timing, side by side.
Read the private vs. marketplace guide →Self-employed? Start here
Freelancers, 1099s, and business owners: your real options, what coverage costs at 40, and the tax deduction most people miss in year one.
Read the self-employed guide →COBRA vs. the marketplace
The letter arrives and the number looks unreal. What COBRA actually costs, the two 60-day clocks nobody tells you about, and when a marketplace plan wins.
Read the COBRA guide →Retiring before 65
Medicare starts at 65. If you stop working before that, one number decides most of what you pay, and there is a deadline most retirees miss by a month.
Read the retiring-before-65 guide →Retiring to Florida
Moving here before Medicare? The enrollment window a move opens, why the network matters more when you're new, and the hospitals around The Villages, St. Johns, Tampa Bay, Vero Beach and Sarasota.
Read the retiring to Florida guide →Adding your kids at work costs too much
Your own coverage is affordable, then adding a child makes the bill jump. The 2022 family glitch fix, child-only Marketplace plans, and moving the whole family together.
Read the family coverage guide →Solid plan or risky one?
Seven things to check on a private-market plan: when the health questions are asked, guaranteed renewable wording, the network, what's paid from the first dollar, and what isn't covered.
Read the plan checklist →Dental and vision
Your plan covers your children’s teeth and eyes, and not yours. That is the law, not a bad plan. What the gap costs and the honest ways to close it.
Read the dental and vision guide →Your coverage timeline
Retiring before 65? Enter your last day of work coverage and your birth date to see your COBRA deadline, your Marketplace window, open enrollment and your Medicare sign-up window, with the official source for each.
Build your timeline →Have a question you want answered? Text me and I'll turn it into a guide.
Rather just ask a real person?
That's what I'm here for. Tell me your situation and I'll walk you through it, free and with no pressure.
Get my options →