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, but it is NOT ACA-compliant: it can exclude pre-existing conditions and essential benefits. The allowed duration depends on each state's rules.

Subsidies: you may pay far less than you think

Many families with incomes between 100% and 400% of the federal poverty level qualify for tax credits that lower their monthly Marketplace premium. The enhanced subsidies expired on December 31, 2025, so in 2026 households above 400% generally no longer receive a tax credit and many net premiums went up. We estimate your real subsidy and help you enroll, in Spanish or English, at no extra 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. In Georgia you enroll through Georgia Access (the state marketplace); in Florida, South Carolina, Tennessee, Alabama, Indiana, and Texas, through HealthCare.gov. 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.

Can I get health insurance without an SSN or without being a citizen?

Many families do not know what health options they have based on their immigration status. We explain the real alternatives in plain language, without judging your situation.

• Citizens and lawfully present individuals can enroll in the Marketplace. Starting with 2027 coverage, tax credits are limited to citizens, green card holders, Cuban/Haitian entrants and COFA migrants; other lawfully present immigrants (refugees, asylees, TPS holders) can buy a plan, but without the subsidy.
• Some carriers offer private or indemnity plans with no immigration-status requirement; they are not ACA major medical coverage and may exclude pre-existing conditions.
• Children may qualify for state programs even when parents do not.
• We help you review your options at no cost and in Spanish, so your family is not left unprotected.

How to choose the right health plan for your family

The cheapest plan is not always the best fit. Choosing well depends on how much you use the doctor, what medications you take and which doctors you want to keep.

• Look at the monthly premium together with the deductible and out-of-pocket maximum, not just the price.
• Confirm that your doctors and hospitals are in the plan network.
• Check that your medications are covered in the plan formulary.
• If you rarely see the doctor, a low-premium plan may work; if you have a condition, a lower deductible is better.