The Blog

Health insurance answers, in plain English

Real questions people ask — what plans actually cover, how the subsidy math works, which enrollment window applies, and honest looks at the carriers. No jargon, no fluff, and no phone number required to read any of it.

All posts

Coverage Questions

Does marketplace insurance cover braces?

September 7, 20267 min read

Rarely for adults, sometimes for kids — and usually only when orthodontia is medically necessary. What marketplace and dental plans actually pay in 2026. Read more →

Coverage Questions

Urgent care vs. the ER: what's covered, and what it costs

September 4, 20267 min read

Both are covered by 2026 marketplace plans — at wildly different prices. Urgent care is usually a copay; the ER runs through your deductible. How to choose. Read more →

Coverage Questions

Does marketplace insurance cover dermatology?

September 2, 20266 min read

Generally yes for medical skin problems — moles, acne, eczema, skin cancer. Cosmetic work is excluded. How the line gets drawn on 2026 marketplace plans. Read more →

Medicare

What is the ANOC letter — and why does it matter this month?

August 31, 20266 min read

Every September, your Medicare Advantage or Part D plan mails an Annual Notice of Change — what your plan will cost and cover next year. Here's the 10-minute, five-check way to read it, and what to do if you don't like what you find. Read more →

Coverage Questions

Does marketplace insurance cover telehealth visits?

August 28, 20266 min read

Almost always yes — but what you pay depends on whether you use the plan's virtual-care vendor or your own doctor's video visit. The 2026 breakdown. Read more →

Coverage Questions

Does marketplace insurance cover you out of state?

August 26, 20267 min read

Emergencies, generally yes, anywhere in the U.S. Routine care out of state usually isn't covered on HMO and EPO plans. Here's how to check yours. Read more →

Coverage Questions

Does marketplace insurance cover physical therapy?

August 24, 20266 min read

Yes — rehabilitative services are an essential health benefit, so PT is generally covered. The catch is the visit cap and medical necessity. 2026 guide. Read more →

Coverage Questions

Does marketplace insurance cover sleep apnea testing and CPAP?

August 21, 20267 min read

Generally yes — the sleep study is medical care and CPAP is equipment. But they're two separate bills, and the machine comes with a usage rule. 2026 breakdown. Read more →

Coverage Questions

Does marketplace insurance cover insulin and diabetes supplies?

August 19, 20267 min read

Yes — prescription drugs are an essential health benefit. The real question is which insulin, what tier, and why the $35 Medicare cap isn't yours. 2026 guide. Read more →

Coverage Questions

Does marketplace insurance cover hearing aids?

August 17, 20267 min read

For adults, usually not — hearing aids aren't an essential health benefit. The hearing test often is, and kids' coverage depends on your state. 2026 guide. Read more →

Coverage Questions

Does marketplace insurance cover chiropractic care?

August 16, 20266 min read

Often, but not always — coverage depends on your state's benchmark plan and the policy, and usually carries a visit cap. How to check yours for 2026. Read more →

Coverage Questions

Does marketplace insurance cover glasses and eye exams?

August 12, 20266 min read

Under 19, generally yes — pediatric vision is an essential health benefit. Adults get medical eye care but rarely routine exams or glasses. The 2026 breakdown. Read more →

Coverage Questions

Does marketplace insurance cover ADHD testing and medication?

August 10, 20267 min read

Generally yes — ADHD care falls under the mental health benefits every ACA plan must cover, and most 2026 formularies list the meds. The catch is prior auth. Read more →

ACA Basics

Self-employed health insurance: how to estimate income and not overpay

August 7, 20267 min read

The marketplace wants your projected net self-employment profit for 2026, not last year's gross revenue. Here's how to build that estimate, which way to lean, and how to avoid owing subsidies back. Read more →

Carrier Reviews

Is Ambetter good insurance? An honest agent's review

August 5, 20268 min read

Ambetter is real ACA coverage and often among the cheapest in a county — but it lives or dies on its network. Here's what an agent checks before recommending it for 2026. Read more →

ACA Basics

Deductible vs. out-of-pocket max: the two numbers that decide what you really pay

August 3, 20267 min read

The deductible is where your spending starts. The out-of-pocket max is where it stops. Here's how the two numbers work together on a 2026 marketplace plan — and what doesn't count toward either. Read more →

ACA Basics

HMO vs. PPO vs. EPO: which network type should you pick?

July 31, 20267 min read

The plan letters describe two things: whether you need referrals, and whether out-of-network care is covered at all. Here's how to pick the right network type for 2026 without overpaying. Read more →

ACA Basics

Turning 26? Your health insurance options, step by step

July 29, 20267 min read

Aging off a parent's plan is a qualifying life event: you get a 60-day Special Enrollment Period. Here's the timeline, every option ranked, and the mistakes that leave you uninsured in 2026. Read more →

Coverage Questions

Does marketplace insurance cover IVF and fertility treatment?

July 27, 20266 min read

Usually not — IVF isn't an essential health benefit, so coverage depends on your state and the specific plan. Here's how to read a plan's fertility benefits before you buy in 2026. Read more →

ACA Basics

Is short-term health insurance worth it in Florida?

July 24, 20267 min read

Short-term health insurance in Florida is cheap for a reason: medical underwriting, excluded pre-existing conditions, and no subsidy eligibility. Here's when it's genuinely the right bridge — and the three situations where it quietly costs more than an ACA plan. Read more →

ACA Basics

COBRA ran out — now what?

July 22, 20266 min read

COBRA exhaustion is a qualifying life event: you get a 60-day Special Enrollment Period for a marketplace plan, often with subsidies COBRA never offered. Here's the timeline, the Medicare trap for anyone 65+, and the mistakes that close doors. Read more →

Coverage Questions

Does marketplace insurance cover pregnancy and childbirth?

July 20, 20267 min read

Yes — maternity and newborn care is a required essential health benefit on every ACA marketplace plan, covered from day one with no waiting period. Here's how the costs actually break down. Read more →

ACA Basics

What happens to my subsidy if my income changes mid-year?

July 20, 20267 min read

Your ACA subsidy is based on your whole year's income — so a raise, job loss, or side-gig surge changes it mid-year. Here's how reconciliation works at tax time, and the 30-day habit that prevents surprise bills. Read more →

Coverage Questions

Does marketplace insurance cover Ozempic, Wegovy and other weight-loss drugs?

July 12, 20267 min read

It depends on the drug and your diagnosis. Ozempic for diabetes is usually covered; Wegovy for weight loss alone often isn't. Here's how coverage actually breaks down plan by plan. Read more →

Coverage Questions

Does marketplace insurance cover dental for adults?

July 12, 20266 min read

Almost never as part of the medical plan itself. Adult dental is an optional add-on on the ACA marketplace, not one of the ten essential health benefits — here's what that means for your wallet. Read more →

Coverage Questions

Does marketplace health insurance cover therapy?

July 10, 20266 min read

Yes — every ACA marketplace plan must cover mental health care, including therapy, as an essential health benefit. What you'll actually pay depends on your plan's copay, deductible, and network. Here's how to check before you buy. Read more →

Can't find your question?

Ask it directly — or run one of the free tools. A licensed agent can compare every plan filed in your county for your exact situation, free, in about 10 minutes.

No cost. No pressure. No obligation to enroll.