ServicesIndividual Health Insurance
Health Coverage for Individuals in New Port Richey
Buying a plan in your own name? We set options from multiple carriers next to each other and explain the rules on what you can buy and when. Each plan's premium, deductible and network sit in plain view, and the consultation costs you nothing.
A plan in your name, picked with the rules explained
An individual plan belongs to you rather than to an employer. People choose one for many reasons: they run a business, they are between jobs, their part-time work has no benefits, they left work sooner than expected, or the plan at work never suited them. Since the policy is yours, switching jobs does not end it.
Shopping alone puts you up against rules that rarely get explained: enrollment windows, income tests for financial help, and the gap between plans that follow the Affordable Care Act and plans that do not. We go through each rule in plain words, show where it touches your situation, and then compare only the plans open to you.
The consultation is free. We are paid by the carrier whose plan you choose, so our review adds nothing to your costs. If a family plan or a separate dental or vision policy would suit you better, we tell you.
What our individual plan review covers
- Side-by-side carrier comparison
- Every plan that fits you goes onto a single comparison sheet drawn from multiple carriers. You read straight across the premium, deductible, out-of-pocket maximum and copays instead of flipping between brochures.
- Network checks for your doctors
- Give us the names of the doctors and hospitals you use. We check whether each plan's network includes them and note whether the plan is an HMO, EPO or PPO, since that changes whether you need referrals or have any out-of-network coverage.
- Medication cost review
- We look up the drugs you take on each plan's formulary and note which tier they fall in. A low premium can lose its appeal quickly if a medicine you rely on sits on the most expensive tier.
- Eligibility for financial help
- Based on your expected income for the year, we estimate whether you qualify for a premium tax credit or reduced cost sharing on a marketplace plan, and explain what happens if your income changes.
- Enrollment handled correctly
- Once you choose, we help you complete the application accurately, including any documents a special enrollment period requires, so coverage starts on the date you expect.
Times when buying your own plan makes sense
Your job is wrapping up
Losing employer coverage opens a special enrollment window, usually 60 days long. Checking individual plans promptly often turns up options that cost less than keeping the old group plan.
You run your own work
Freelancers, contractors and small business owners without a group plan must buy their own coverage, and plenty of them qualify for help with the premium.
Your renewal has changed
Carriers adjust premiums, networks and drug lists each year. If your renewal brings a higher price or a doctor dropped out of the network, compare before open enrollment closes.
You just reached 26
Coverage on a parent's plan generally ends at 26. Turning 26 counts as a qualifying event, so you can get your own plan without waiting for fall.
You are unsure what your plan covers
Some individual policies are short-term or limited plans that sit outside ACA rules. If you do not know which kind you have, we will review it with you.
How a consultation runs
- 1
A short phone conversation
We ask about your age, county, expected income, the doctors you see and the medications you take. Meet us at our office or by phone or video, whichever is easier.
- 2
The rules that apply to you
We tell you which enrollment window you are in, whether you qualify for financial help, and which plan types are open to you. Nothing is assumed.
- 3
Your options side by side
We present the plans that fit, with premiums, deductibles and network notes laid out together. We point out the catch in each one, not just the strengths.
- 4
Enrollment and follow-up
When you decide, we go through the application with you on the phone, answer each question together and confirm the start date with the carrier. If something comes up once you start using the plan, give us a call and we will look into it.
What sets the price of an individual plan
Individual premiums are set by a short list of factors, and most are not about your health history. Knowing them makes it easier to see why two quotes differ and where you have real choices.
- Age and tobacco use
- ACA plans can charge more as you get older and can add a surcharge for tobacco users. These are the two personal factors that move a premium most.
- Metal tier
- Bronze plans have lower premiums and higher deductibles. Silver, gold and platinum shift more of the cost into the monthly premium in exchange for lower costs when you use care.
- Network type
- HMO and EPO plans usually cost less than PPO plans because they limit coverage to a set network. If your doctors are in network, that can be a sensible saving.
- Your income
- Income does not change the sticker price, but it decides how much of the premium a tax credit covers on a marketplace plan. For many clients this is the biggest factor of all.
- Where you live
- Prices are set by rating area, and carriers in your county may differ from those a few counties away.
Individual health insurance: common questions
Something not covered here? (727) 609-4129
When am I able to buy an individual plan?
For Florida marketplace plans, the main window is open enrollment, from fall to mid-January. At other times you need a qualifying change, such as losing other coverage, moving to another county, getting married or having a baby. One short call tells you whether your change qualifies.
Will a health condition keep me from getting a plan?
Not with an Affordable Care Act plan, which cannot turn you down or charge more because of your health history. Short-term and some limited plans can, so we lay out that difference before you choose.
Do I really pay nothing for your help?
Right. There is no consultation fee; our commission comes from the carrier you sign up with. Your premium is the same as buying that plan directly.
How is a deductible different from an out-of-pocket maximum?
Your deductible is what you pay toward covered care each year before the plan begins to share costs. The out-of-pocket maximum is the ceiling: once your deductible, copays and coinsurance add up to it, the plan covers the rest of that year's covered costs.
Should I buy on the marketplace or off it?
Premium tax credits apply only to marketplace plans, so that counts if you might qualify. If you would not, plans sold off the marketplace are worth comparing too. Our ACA Marketplace Plans page explains the marketplace in more depth.
See your individual plan options laid out clearly
One conversation covers your enrollment window, your eligibility for help and the plans that fit. The consultation is free, and you decide in your own time.