Health coverage without the guesswork

Premium is not the price

The number on the plan card is the premium. What you actually pay across a year is the premium plus the deductible you have to meet, plus copays and coinsurance, up to the out-of-pocket maximum. A cheaper premium with a high deductible can cost far more than a dearer plan if you need care.

We work it the other way round: start from the care you expect to use, then find the plan that costs least across the whole year.

Subsidies

Many people qualify for a premium tax credit and do not realise it, and some also qualify for cost-sharing reductions that lower deductibles and copays — but only on Silver-level plans. Eligibility depends on your household income estimate for the coverage year, not last year's. We check this before you enrol, because correcting it afterwards means reconciling at tax time.

Enrolment windows

Open Enrolment runs from 1 November to 15 January in most states. Outside that window you need a Special Enrolment Period, triggered by events such as losing other coverage, moving, marriage, or having a child. These generally give you 60 days. If something has changed in your life, call — you may have a window open right now that closes soon.

What we will tell you plainly

• If your doctor is not in a plan's network, before you enrol rather than after
• If a plan is a poor fit for your prescriptions
• If you would be better off on coverage we do not sell, including through your employer or a public programme