Insurance Questions? We Have Straight Answers.

Individual health insurance plans in 2025 range from approximately $89 to $500+/month before subsidies, depending on your age, location, plan metal tier, and tobacco use. Silver plans for a 30-year-old average around $350–$450/month before tax credits. Many individuals and families qualify for ACA premium tax credits that significantly reduce these amounts — sometimes to $0. Your Benefits Hub agent will calculate your exact pricing at no cost.

Your deductible is the amount you pay for covered services before your insurance starts sharing costs. Your out-of-pocket maximum is the most you'll ever pay in a calendar year before your insurance covers 100% of covered in-network costs. Once you hit your out-of-pocket maximum — including deductibles, copays, and coinsurance — your plan pays everything for the rest of the year.

A copay is a fixed dollar amount you pay for a specific service — for example, $30 for a primary care visit. Coinsurance is a percentage of the cost you pay after your deductible is met — for example, 20% of a $1,000 procedure means you pay $200. Some plans use copays, some use coinsurance, and some use both.

It depends on whether your current doctors are in the new plan's network. Benefits Hub cross-checks your current physicians, hospitals, and specialists against the network directories of every plan we recommend — before you enroll. We never let a client switch plans without knowing whether their preferred providers are covered.

An HSA is a tax-advantaged savings account paired with a High-Deductible Health Plan (HDHP). You contribute pre-tax dollars (2025 limits: $4,150/individual, $8,300/family) and use the funds tax-free for qualified medical expenses — including deductibles, copays, prescriptions, dental, vision, and more. Unlike FSAs, HSA funds roll over year to year with no expiration. Over time, an HSA can become a powerful retirement health savings vehicle.

Open Enrollment is the annual window during which you can sign up for, change, or drop an ACA health insurance plan. For 2026 coverage, Open Enrollment runs from November 1 to January 15, 2026. Outside of Open Enrollment, you can only enroll if you experience a qualifying life event (job loss, marriage, birth, move). Some short-term and off-exchange plans are available year-round.

A qualifying life event triggers a Special Enrollment Period (SEP) — a 60-day window to enroll in or change health insurance outside of Open Enrollment. Qualifying events include: losing job-based health coverage, getting married or divorced, having a baby or adopting, moving to a new state or ZIP code, aging off a parent's plan at 26, becoming a U.S. citizen, or a change in household income that affects subsidy eligibility.

If your household income is between 100% and 400% of the Federal Poverty Level (FPL), you qualify for ACA premium tax credits. Under current legislation, even households above 400% FPL may qualify for some subsidy. For a single person, 100% FPL in 2025 is approximately $14,580/year. For a family of four, it's $30,000/year. A family of four earning up to $124,800 may still qualify for meaningful subsidy assistance.

In-network providers have negotiated rates with your insurance carrier, meaning your insurance pays a higher percentage of costs and your share is lower. Out-of-network providers have no such agreement — costs are higher, your share is greater, and some plan types (HMOs) won't cover out-of-network care at all except in emergencies. PPO plans offer the most flexibility for out-of-network care.

Most ACA health plans do not include adult dental or vision coverage — these require separate standalone plans. Benefits Hub offers dental plans starting at $19/month and vision plans starting at $12/month, or combination bundles for both starting around $28/month. Pediatric dental and vision are included in ACA children's plans by law.