Health insurance, explained properly
Guides, articles and the official places to check things yourself. No sign-up and no email required. If it helps you decide, it belongs here.
The six things that confuse almost everyone
Explained properly. No sign-up, no email required.
How premium tax credits actually work
The credit is based on the income you expect to earn next year, not last year’s tax return. You estimate it, the Marketplace advances the credit to the carrier each month, and the IRS reconciles the difference when you file.
- Estimate high and you get a refund; estimate low and you may owe
- Report income changes during the year — it adjusts the credit
- Self-employed income is the hardest to estimate and the most worth getting right
Bronze, Silver, Gold — what the metals mean
The metal level describes how you and the plan split costs, not the quality of care. Bronze means a lower premium and more out of pocket when you use it. Gold is the reverse. Silver is the only level where cost-sharing reductions apply if you qualify.
- If you rarely use care, Bronze can still cost more after one bad month
- Silver plus a cost-sharing reduction often beats Gold on total cost
- Every metal level covers the same ten essential benefits
Deductible, copay, coinsurance, out-of-pocket max
Four numbers decide what a year actually costs you. The deductible is what you pay before the plan starts sharing. Coinsurance is the percentage you keep paying after that. The out-of-pocket maximum is the ceiling, the most you can lose in a bad year.
- Compare the out-of-pocket maximum, not just the premium
- Copays for primary care often apply before the deductible
- Prescriptions can sit on a separate tier structure entirely
What counts as a qualifying life event
Outside Open Enrollment you need a qualifying life event to enroll, and you generally have sixty days from the event. Losing coverage counts. Voluntarily dropping coverage doesn’t.
- Losing job coverage, marriage, a baby, adoption, divorce
- Moving to a new ZIP code with different plans available
- Turning 26 and coming off a parent’s plan
How Medicaid and CHIP eligibility is decided
Your state decides, not the Marketplace and not me. Eligibility turns on household size and monthly income, and the thresholds differ sharply between states that expanded Medicaid and those that didn’t.
- There’s no enrollment deadline — you can apply any month
- Children often qualify through CHIP when parents don’t
- Neither pays a broker commission, which is why some never mention it
SHOP, QSEHRA and ICHRA compared
Three different ways a small employer can fund coverage. SHOP is a traditional group plan bought through the Marketplace. QSEHRA and ICHRA reimburse employees tax-free for individual plans they choose themselves.
- SHOP may carry a federal tax credit for smaller employers
- QSEHRA has annual caps; ICHRA doesn’t, but has class rules
- Reimbursement models shift plan choice to the employee
Written for the question you actually have
Health insurance for realtors in Florida
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Read it → Leaving a jobCOBRA alternatives
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Only 59 percent of small firms offer health benefits, against 97 percent of large ones. That gap is where your best employee gets recruited. What coverage really costs, the credit most owners never claim, and when a group plan is the wrong move.
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For drivers, a nationwide private plan is often the better buy, until it isn’t. The honest breakdown of when private wins and when an ACA plan is the only one that will do what you need.
Read it → Travel cliniciansTraveling for work? Your health plan probably isn’t.
Travel nurses, NPs, PAs, paramedics and rad techs take contracts across state lines. Most Marketplace plans are built around one ZIP code. Here’s what actually covers you on assignment, and what doesn’t.
Read it → Open Enrollment 2027Why your premium jumped, and what to do about it
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Read it → Self-employed & 1099The health insurance deduction most 1099 workers miss
Your premiums may come straight off your income, without itemizing. What qualifies, the four rules that trip people up, and why your income estimate and your deduction are the same conversation.
Read it →Check it yourself
Official sources, not my summary of them. Everything I tell you should be verifiable somewhere on this list.
On prescription discounts: a coupon price usually does not count toward your deductible or out-of-pocket maximum, and you can’t use it together with your insurance on the same fill. Sometimes cash is still the cheaper choice. Bring it to our call and we’ll work out which way costs you less over the year.