If you’re under 65 and buying your own health insurance, you already know the hard part isn’t finding a plan. It’s working out which of them is actually good — and whether the cheap one is cheap for a reason.
I’m not tied to one company or one route, so I can look at everything available to you and tell you plainly where the trade-offs are. There’s no charge for the help.
Who ends up buying their own coverage
- Self-employed — no group plan to fall back on
- Between jobs — or looking at a COBRA quote and wondering if there’s a better option
- Retired before 65 — with a gap to bridge until Medicare starts
- Working somewhere without benefits — part-time, contract, or gig work
- Family members who aged off a parent’s plan at 26
The right answer looks different for each of these, which is why a quick conversation beats a quote engine.
Route one: the ACA Marketplace
Marketplace plans are the ones most people know about — the metal tiers, guaranteed acceptance regardless of health history, and the essential benefits every plan has to cover.
The piece people routinely get wrong is the subsidy. Premium tax credits are based on household income relative to the federal poverty level — and for 2026 there is a hard ceiling on them again. The temporary expansion that ran from 2021 through 2025 expired on 1 January 2026, so above 400% of the federal poverty level the credit is zero rather than reduced. Below that line the help is real and worth claiming; above it, the private route is usually the comparison that matters. What changed in 2026 explains it in full, and if you are bridging to Medicare, retiring before 65 covers the whole span. Just lost job coverage? Start here — there is a clock on it. I regularly talk to people who never checked because they were sure they earned too much — and who turn out to qualify for a meaningful credit.
It’s worth five minutes to find out rather than assuming. If a Marketplace plan with a subsidy is your best route, I’ll help you enroll in it.
Route two: private plans outside the Marketplace
If your income puts you past the subsidy range, the picture changes. A full-price Marketplace plan can be an expensive way to buy coverage, and there are private options worth comparing against it.
These plans work differently from Marketplace coverage. Most ask health questions, which means they aren’t available to everyone — but for people in reasonable health they can offer a stronger benefit for the money. The ones I work with use PPO networks, so you keep the freedom to see specialists without a referral and you aren’t locked into a narrow local network.
You may also come across reference-based pricing. Instead of a negotiated network rate, these plans pay providers a set multiple of the Medicare rate. It can lower costs considerably, and it behaves differently at the doctor’s office than a traditional PPO does — so it’s something to walk through properly before choosing it, not something to pick off a comparison chart.
I’ll show you both routes side by side. Sometimes the Marketplace wins. Sometimes it isn’t close. It depends on your income, your health, and which doctors you want to keep.
What to compare, beyond the premium
The monthly cost is the number everyone looks at first and the one that tells you least on its own. Before choosing, check:
- Your doctors. Are the ones you actually see in the network — not just “a hospital nearby”?
- Your prescriptions. Every plan has its own drug list, and the same medication can sit at very different tiers.
- The deductible and the out-of-pocket maximum. The maximum is the number that matters in a bad year — it’s your worst case.
- How it handles the ordinary stuff. Office visits, urgent care, labs and imaging, before you’ve met the deductible.
- Whether it’s a full major medical plan. Short-term and limited-benefit products have a place, but they aren’t the same thing, and you should know which you’re buying.
Common questions
How do you get paid — and what does that mean for me?
The insurance carrier pays the agent a commission that is already built into the premium — so your price is identical whether you enroll through me or go direct. What changes is what you get for it: someone who compared the options across carriers, explains the trade-offs in plain language, and still answers the phone next year. And here it is me every time — not a call center, and never a different agent each call.
Can I only sign up at the end of the year?
For Marketplace plans, generally yes — open enrollment — unless you have a qualifying life event such as losing job-based coverage, moving, marriage, or a new child, which opens a special enrollment period. Private plans outside the Marketplace often accept applications year-round. If you’ve just lost coverage, don’t wait to ask.
I have a pre-existing condition. What are my options?
Marketplace plans cannot decline you or charge you more for your health history — that’s the route built for exactly this situation. Private medically-underwritten plans can decline applicants, so the Marketplace is usually the stronger option if you have significant health conditions.
Is COBRA my best choice after leaving a job?
Sometimes — particularly mid-treatment, when keeping the exact same network and deductible progress matters. But COBRA means paying the full premium your employer was partly covering, and losing that coverage is a qualifying event that opens a special enrollment period. Compare both before you elect it — the order matters, because electing COBRA first can affect whether you qualify for help on the Marketplace.
What does your help cost?
Nothing. I’m paid by the insurance carrier, and your premium is the same whether you enroll through me or on your own.
Let’s figure out which route fits
Bring me your household income, the doctors you want to keep, and any prescriptions you’re on, and I’ll come back with what’s actually available to you — both routes, honestly compared.
Call or text 770-765-7007. I work with individuals and families throughout North Georgia: Forsyth, Cherokee, Hall, Dawson, Lumpkin, Pickens, Gilmer, Fannin, Union and White counties, plus north Gwinnett and north Fulton.
If a call is easier scheduled than made, choose a time here and I will ring you then.
Prefer to look for yourself first? You can browse Marketplace plans and check your subsidy here. If anything is unclear — and it usually is — call me and we’ll go through it together.
Also worth a look
- Life insurance — term, whole life, and final expense explained
- Turning 65? — no-cost help getting Medicare right
- Retirement income planning — turn savings into income that lasts
- Request a quote — tell me what you need and I’ll follow up
Serving North Georgia: Forsyth County · Cherokee County · Hall County · north Gwinnett · north Fulton · Dawson County · Lumpkin County · Pickens County · Gilmer County · Fannin County · Union County · White County. Including Cumming · Canton · Holly Springs · Woodstock · Dawsonville · Dahlonega · Ball Ground, and the surrounding area.