Individual and Family Health Insurance

Who buys individual coverage

• Self-employed people, contractors and gig workers
• Early retirees who are not yet Medicare eligible
• People between jobs, or leaving a job with COBRA as the alternative
• Employees whose employer does not offer coverage, or offers coverage they cannot afford for dependents
• Adults aging off a parent’s plan at 26

What our help costs you

Nothing. Plan prices are set by the carrier and are the same whether you buy through a broker, through the exchange directly, or from the insurer. Using a licensed broker does not add a markup. We are compensated by the carrier, so the only thing you spend is the time it takes to have the conversation.

What we actually check for you

Choosing on premium alone is the most common and most expensive mistake in individual coverage. The lowest monthly payment often carries the highest deductible, the narrowest network, and a drug formulary that does not include the medication you take.

We check the things that determine whether the plan works in practice:

• Whether your current doctors and preferred hospitals are in network
• Whether your prescriptions are on the formulary and at what tier
• What you would actually pay in a normal year and in a bad year, not just the premium
• Whether you qualify for a premium tax credit or cost-sharing reduction

Enrollment timing

Individual coverage is generally only available during the annual open enrollment window, or during a special enrollment period triggered by a qualifying life event such as losing job-based coverage, moving, marrying, or having a child. Special enrollment periods have short deadlines, usually measured in weeks from the event.

If something has changed in your life, call sooner rather than later. Most of the people we cannot help are people who called after the window closed. More detail on the state exchange is on our Washington Healthplanfinder page.