PERSONAL SOLUTIONS
Health Insurance
Navigate plan types, networks, and enrollment windows with an advisor who works for you.
HEALTH INSURANCE OVERVIEW
Navigate the health insurance market with an advisor, not a website.
Whether you're between jobs, starting a business, aging off a parent's plan, or retiring before Medicare, health insurance decisions are confusing and the stakes are high. We help healthcare professionals — people who understand medicine but don't have time to decode bronze vs. gold vs. catastrophic — find the right individual or family coverage at the right price.
ACA marketplace plans
Comprehensive individual and family coverage through the NY State of Health exchange. Income-based subsidies can significantly reduce premiums.
Short-term health insurance
Temporary coverage for gaps between employer plans — job transitions, business launches, waiting periods.
Supplemental coverage
Accident, critical illness, and hospital indemnity plans that pay cash benefits on top of your primary insurance.
COBRA & gap coverage
Continuation of your employer's group plan for up to 18 months. We help you compare COBRA cost vs. marketplace alternatives.
COVERAGE OPTIONS
Health Insurance Options
The main types of health insurance coverage we help clients navigate.
ACA Marketplace Plans
Comprehensive individual and family coverage through the NY State of Health exchange. Income-based subsidies available.
Short-Term Health
Temporary coverage for 3–12 month gaps between employer plans. Lower premiums but limited benefits.
Supplemental Coverage
Accident, critical illness, and hospital indemnity plans that pay cash benefits on top of primary insurance.
COBRA Continuation
Continue your employer's group plan for up to 18 months. Full premium plus 2% admin fee.
OUR PARTNERS
We work with trusted health insurance carriers.
WHAT YOU NEED TO KNOW
What Health Insurance Covers — and What It Doesn't
What Health Insurance Covers
- Preventive care
Annual physicals, screenings, immunizations — no cost-sharing under ACA-compliant plans.
- Hospitalization
Inpatient care, surgery, and overnight stays at in-network facilities.
- Prescription drugs
Formulary medications with tiered copays. Specialty drugs may require prior authorization.
- Mental health & substance abuse
Therapy, psychiatric care, and substance abuse treatment — parity required under federal law.
- Maternity & newborn care
Prenatal visits, labor/delivery, and postnatal care for mother and child.
- Lab work & diagnostics
Blood tests, imaging, pathology — typically covered with copay or coinsurance.
- Emergency services
ER visits covered at in-network rates regardless of facility, under the No Surprises Act.
What Health Insurance Does NOT Cover
- Cosmetic procedures
Elective surgeries for appearance rather than medical necessity.
- Long-term custodial care
Ongoing daily living assistance — covered by long-term care insurance, not health insurance.
- Long-term disability income
Health insurance pays medical bills — it does not replace your paycheck if an illness or injury prevents you from working for months or years.
- Short-term disability income
Even a 6-week recovery from surgery means 6 weeks without a paycheck. Health insurance covers the surgery — not the lost income during recovery.
- Experimental treatments
Investigational drugs and procedures not yet FDA-approved are typically excluded.
- Overseas medical care
Most domestic plans exclude international coverage. Travel health insurance fills this gap.
- Workers' compensation injuries
Work-related injuries and illnesses are covered by workers' comp, not personal health insurance.
KEY CONSIDERATIONS
What to Think About When Buying Health Insurance
01
Know your enrollment windows
ACA open enrollment is November–January. Outside that window, you need a qualifying life event (job loss, marriage, new baby, relocation) to enroll. Missing the window means waiting up to 11 months.
02
Compare plans on more than premium
A $200/month plan with a $8,000 deductible costs more than a $350/month plan with a $2,000 deductible if you actually use healthcare. We model your expected utilization to find the plan that minimizes total annual cost.
03
Check subsidy eligibility
ACA premium tax credits are income-based and can cut your premium significantly. If you're in a transition year with lower income, you may qualify for subsidies you wouldn't normally get.
04
Don't let a gap become a crisis
Even a 30-day gap in coverage can result in a six-figure bill from a single ER visit. If you're transitioning between plans, we make sure there's no gap.
COST CONTEXT
What Health Insurance Actually Costs
ACA marketplace bronze plans run $300–600/month for individuals in New York. Silver plans: $400–800. COBRA continues at your employer's group rate plus 2%. Income-based subsidies can cut marketplace premiums significantly — sometimes by 50% or more.
What Drives Your Premium
Age, location (New York rates vary by county), plan metal tier, tobacco use, and household income for subsidy eligibility. Family size matters for marketplace plans.
The Total Cost Picture
Monthly premium is only part of the equation. Deductibles, copays, coinsurance, and out-of-pocket maximums determine what you actually pay when you use care. We model total annual cost, not just premium.
FAQ
You've Got Questions. We've Got Answers.
Common questions about health insurance for healthcare professionals.
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Your Coverage Should Work as Hard as You Do
Let's review what you have and make sure it actually protects what matters most.