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What you need to know before choosing a plan
Health insurance protects you from the high cost of medical care. Without coverage, a single emergency room visit can cost $2,000 to $5,000, a hospital stay can exceed $10,000 per day, and surgery can run into six figures. Health insurance spreads these costs across monthly premiums, deductibles, and copays so that a medical event doesn't become a financial crisis.
The Affordable Care Act (ACA) requires all major medical plans to cover 10 essential health benefits: doctor visits, emergency care, hospitalization, maternity and newborn care, mental health and substance abuse services, prescription drugs, rehabilitative services, laboratory tests, preventive and wellness services, and pediatric services including dental and vision for children.
Under the ACA, insurers cannot deny you coverage or charge more based on pre-existing conditions like diabetes, asthma, heart disease, or prior cancer treatment. This means everyone has access to comprehensive coverage regardless of health history.
Your monthly payment to maintain coverage. This is what you pay whether or not you use medical services. Lower premiums typically mean higher out-of-pocket costs when you need care.
The amount you pay out of pocket before your insurance starts covering costs. For example, with a $2,000 deductible, you pay the first $2,000 of covered services each year.
A fixed amount you pay for specific services, such as $30 for a primary care visit or $50 for a specialist. Copays apply even after you meet your deductible on most plans.
The most you will pay in a year for covered services. Once reached, your insurance pays 100% of covered costs. For 2026, the ACA limits this to $9,450 for individuals and $18,900 for families.
Your share of costs after meeting your deductible, expressed as a percentage. With 20% coinsurance, you pay 20% and insurance pays 80% until you reach your out-of-pocket maximum.
The group of doctors, hospitals, and pharmacies that contract with your insurance plan. Using in-network providers costs significantly less. PPO plans offer some out-of-network coverage while HMO plans typically do not.
Understanding which plan type fits your situation
Not sure which plan type is right for you? Our licensed agents will help you compare options based on your specific needs and budget.
We've partnered with a vast network of providers, preferred doctors, and hospitals to ensure you have access to top-tier medical care. With us, you can choose the healthcare professionals you trust most, all while benefiting from cost savings and convenience. Experience peace of mind knowing that quality healthcare is readily accessible.
Your health is your greatest asset, and it deserves personalized care. We're here to provide you with individual health insurance coverage that's tailored to your unique needs. We understand that every person's healthcare journey is different, and that's why our plans are flexible and customizable. With our individual health insurance, you have the freedom to choose the coverage that suits you best, ensuring that you get the care you deserve when you need it. Our policies offer comprehensive benefits and access to a wide network of healthcare providers. Take control of your health and well-being by requesting a quote today. Your health, your choice, our commitment.
Get Individual Quote
We understand that your family's well-being is your top priority. That's why we offer comprehensive and affordable family health insurance coverage that puts your loved ones first. With our plans, you can rest easy knowing that you have access to a network of top-notch healthcare providers, ensuring that your family receives the best care when they need it most. We believe that health insurance should be simple and stress-free, which is why our policies are designed with you in mind. Whether it's preventive care, doctor visits, or emergencies, we've got you covered. Take the first step in securing a healthier future for your family by requesting a quote today. Let us be your partner in safeguarding the health and happiness of those you hold dear.
Get Family Quote
Life is full of unexpected twists and turns, and sometimes you need health coverage that fits your changing circumstances. We offer short-term health insurance coverage designed to provide you with flexibility and peace of mind. Whether you're in between jobs, waiting for your employer's coverage to start, or simply need temporary health insurance, our short-term plans have you covered. With affordable premiums and a quick and easy enrollment process, you can have the protection you need, when you need it most. Our short-term health insurance plans offer a range of benefits, including access to healthcare providers and essential services. Take control of your healthcare decisions and secure your well-being with short-term coverage. Request a quote today and enjoy the confidence of knowing you're prepared for whatever life throws your way.
Get Short-Term QuoteMost Americans qualify for financial help to lower their monthly premiums
Health insurance costs vary based on your age, location, plan type, and whether you use tobacco. The ACA marketplace uses metal tiers to categorize plans: Bronze plans have the lowest premiums but highest out-of-pocket costs, while Platinum plans have the highest premiums but cover the most when you need care. Silver and Gold plans fall in between.
Premium tax credits (subsidies) can significantly reduce what you pay. If your household income falls between 100% and 400% of the federal poverty level, you likely qualify. For a single person in 2026, that means income roughly between $15,060 and $60,240. A family of four may qualify with income up to approximately $124,800. Many people with subsidies pay less than $100 per month for comprehensive coverage.
If you don't qualify for marketplace subsidies, short-term health insurance plans offer coverage starting at $59 per month. These plans provide protection against major medical expenses while keeping monthly costs low. Our agents will calculate your exact subsidy amount and show you all available options at every price point.
All ACA-compliant major medical plans must cover these services
Inpatient hospital stays, surgeries, and overnight care are covered. Learn more
Primary care and specialist office visits with set copays. Learn more
Generic and brand-name medications at tiered pricing. Learn more
Emergency room visits covered at in-network rates even out of network. Learn more
Prenatal visits, delivery, and newborn care covered from day one. Learn more
Therapy, counseling, and psychiatric care at parity with medical care. Learn more
Annual checkups, vaccines, and screenings at no cost in-network. Learn more
Physical therapy, occupational therapy, and speech-language services. Learn more
Blood tests, imaging, X-rays, and diagnostic procedures. Learn more
Children's health care including dental and vision coverage. Learn more
Real experiences from people we've helped
"The agent was incredibly helpful and patient. She found me a plan that saved me $200/month compared to what I was paying before. The whole process took less than 30 minutes!"
- Sarah M., Texas
"I was overwhelmed by all the options until I called. My agent explained everything clearly and helped me find coverage that included my doctors. Highly recommend!"
- Michael R., Florida
"After losing my job, I thought I couldn't afford health insurance. They found me a subsidized plan for less than $100/month. Such a relief for my family!"
- Jennifer L., California
Quick answers to the most common health insurance questions
Have more questions? Visit our full FAQ page or call (888) 817-0413 to speak with a licensed agent.
We help individuals and families across the United States find affordable health insurance
Our licensed agents serve 48 states and work with over 50 insurance carriers to find you the best coverage at the best price. Whether you live in a state that runs its own health insurance marketplace or uses the federal HealthCare.gov platform, we can help you navigate your options.
Health insurance plans and pricing vary significantly by state and even by county. Factors like available carriers, state regulations, local healthcare costs, and Medicaid expansion status all affect your options. That's why working with a knowledgeable agent who understands your local market matters.
Plans are available through South Salem Health Insurance Agency, LLC, a subsidiary of Convert IQ, licensed and appointed in all operating states. View our licensing information.
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