How much will this cost me per month?
Your monthly cost depends on age, ZIP, household size, and income. After subsidies, most TBB clients pay $0–$300/month. We quote every carrier on a single call so you see real numbers, not estimates.
FAQ · Video Library
Get ready for your appointment.
20 short videos covering the most-asked questions about cost, coverage, and what to expect. Each one is under 5 minutes.
Section 1 · 6 videos
Costs & Billing
How does my income affect eligibility and cost?
ACA premium tax credits scale with household income relative to the federal poverty level. Lower income = larger subsidies. Through 2026, even households above 400% FPL get credits capped at 8.5% of income for the benchmark Silver plan.
Do I qualify for subsidies or financial assistance?
Most households between 100%–400% of FPL qualify for premium tax credits. Through 2026, households above 400% FPL also receive credits. Cost-Sharing Reductions add savings on Silver plans for households under 250% FPL.
What is a deductible, and how does it work?
Your deductible is what you pay out of pocket for covered services before insurance starts paying. A $3,000 deductible means you cover the first $3,000 of bills (preventive care is always free). Lower premiums usually mean higher deductibles.
What are my copays for doctor visits, specialists, and the ER?
Copays vary by plan: primary care $20–$50, specialist $40–$90, urgent care $50–$100, ER $250–$500+. Some plans waive copays for telehealth. We show the full copay schedule before you enroll.
Can I change, downgrade, or cancel my plan later?
Outside Open Enrollment, plan changes require a qualifying life event. You can cancel ACA coverage anytime, but going uninsured carries real risk. If cost becomes an issue, contact us first we can often find a lower-cost option or adjust your subsidy.
Section 2 · 9 videos
Coverage Explained
What does this plan actually cover health, dental, and vision?
ACA plans cover 10 essential benefits: doctor visits, hospitalization, ER, prescriptions, mental health, maternity, preventive care, peds, rehab, labs. Adult dental and vision are usually separate; pediatric dental and vision must be available alongside ACA plans.
Does this plan cover my prescriptions?
Every plan has a formulary a tiered list of covered drugs. We check your specific medications against each plan's formulary so you know exactly what your monthly Rx cost will be. We never recommend a plan that doesn't cover what you're taking.
Can I keep my current doctor if I switch plans?
Usually yes, but it depends on the plan's network. We verify your providers are in-network before recommending coverage. Switching plans almost always involves some network change we flag it explicitly so you can choose with full information.
Is there a waiting period, and what's covered from day one?
ACA plans have no waiting periods and no pre-existing condition exclusions full coverage from the effective date. Private plans (MEC, indemnity, short-term) may have waiting periods for certain benefits, and we always disclose these upfront.
What's the difference between an HMO, PPO, and indemnity plan?
HMO: lower cost, in-network only, referrals required. PPO: more flexibility, out-of-network coverage, no referrals, higher premium. Indemnity: pays you a fixed amount per service no network restrictions but no negotiated rates either.
Marketplace vs Private plans why can Private be cheaper?
Marketplace plans cover everything required by the ACA, which makes them more expensive without a subsidy. Private plans (MEC, indemnity, short-term) cover fewer services they can cost less because they're paying out less. Best for healthy people who don't qualify for subsidies.
What is supplemental insurance, and do I actually need it?
Supplemental insurance (accident, critical illness, hospital indemnity, dental, vision) pays you cash when specific events happen. It fills gaps in your major medical plan. Whether you need it depends on your deductible, health, and how much risk you can absorb. We'll walk the math.
How does critical illness or accident coverage work?
Critical illness pays a lump sum if you're diagnosed with a covered condition (heart attack, stroke, cancer, etc.). Accident coverage pays a benefit for covered injuries and ER visits. Both pay you directly. They pair well with high-deductible major medical plans.
What if I have a pre-existing condition?
ACA marketplace plans cannot deny coverage, charge you more, or exclude benefits based on a pre-existing condition. Period. Private plans may underwrite based on health your advisor will explain which products apply and steer you to the ACA path if needed.
Section 3 · 5 videos
Common Questions
I missed open enrollment what can I do?
You may qualify for a Special Enrollment Period (SEP) if you've had a qualifying life event in the last 60 days: lost coverage, moved, married, divorced, had a baby, aged off a parent's plan. If you don't qualify for an SEP, Private plans are available year-round.
When does my coverage start after I enroll?
ACA coverage typically starts on the first of the following month if you enroll before the 15th. Private plans often start within 1–14 days. Your advisor confirms the exact effective date during enrollment and emails your member ID once issued.
How do I file a claim or use my benefits once I'm enrolled?
In-network providers file most claims for you. For out-of-network or supplemental benefits, you submit a claim form (online or by mail) with the itemized bill. If anything goes sideways with a claim, call us claim help is part of our year-round support.
What happens after I enroll do you still help me?
Yes. Your TBB advisor stays your point of contact for renewals, ID card issues, claim questions, network changes, and mid-year life events. We're a year-round broker, not an open-enrollment-only service. Same advisor, same direct line.
Are you an independent broker, or do you only work with one company?
Independent. Every TBB advisor is contracted with every major carrier in your state Blue Cross, Aetna, UnitedHealthcare, Cigna, Humana, Oscar, Molina, Ambetter, Kaiser, Anthem, and regional carriers. We shop your whole market and recommend what fits, not what any single carrier wants us to sell.
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