Health Insurance

What is health insurance and why you need it

Health insurance covers part of your medical costs: doctor visits, medications, hospital stays, and emergencies. In exchange for a monthly premium, the insurer pays most of your medical bills after you meet your deductible, protecting you from debts that can reach tens of thousands of dollars.

Without insurance, a single medical emergency can financially ruin you. Also, many plans cover preventive care (checkups, vaccines) at no cost, helping you stay healthy and catch problems early.

Types of health insurance plans

Choosing the right plan depends on your budget, your doctors, and your needs. These are the most common types:

• HMO: lower premiums, but you must use the network and need a referral for specialists.
• PPO: more flexibility to choose doctors and specialists without a referral, at a higher cost.
• EPO: a network like an HMO but without needing referrals.
• Marketplace (ACA) plans: organized in Bronze, Silver, Gold, and Platinum tiers based on how much you pay monthly vs. per service.
• Short-term insurance: cheaper temporary coverage while you find a permanent plan.

Subsidies: you may pay far less than you think

Many families qualify for government subsidies (tax credits) that dramatically reduce their monthly Marketplace premium. Some people pay as little as a few dollars a month. We calculate your subsidy and help you enroll, all in Spanish and at no cost.

Key terms you should know

Understanding these terms helps you compare plans with confidence:

• Premium: what you pay each month to have the plan.
• Deductible: what you pay out of pocket before insurance starts covering.
• Copay: a fixed amount you pay for a visit or medication.
• Coinsurance: the percentage you share with the insurer after the deductible.
• Out-of-pocket max: the annual cap you will pay; after that insurance covers 100%.

When can I enroll?

Annual open enrollment is the main season to choose a Marketplace plan. But if you had a qualifying life event (losing your job, getting married, having a baby, or moving), you may qualify for a special enrollment period outside that season. Contact us and we will check if you are eligible.