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Coverage Options

Private, Marketplace and group plans, under one advisor.

Most people are shown one slice of the market and asked to choose from it. We compare the whole picture — including the plans that never appear on a public website — and tell you plainly which one fits.

Three people gripping each other's wrists in a linked square over a desk
One advisor, every marketPrivate, Marketplace, group and COBRA alternatives sit in four separate places. Comparing them properly means holding all four at once — which is the whole job.
A pharmacist facing shelves of prescription medication
Your prescriptions, checkedA formulary decides whether your medication costs a copay or the full retail price. We check the tier before you enrol, not at the counter afterwards.
A surgical team at work in an operating theatre
The bad year matters mostA plan is cheap until something serious happens. Deductible, out-of-pocket maximum and network reach are what decide whether a hospital stay is manageable or ruinous.

There are four distinct health insurance markets available to most people, and almost nobody sees all four. The Marketplace shows you Marketplace plans. A carrier's website shows you that carrier's plans. Your employer shows you what they bought. Each is a partial view, and each looks complete from the inside.

Individual and family coverage

The largest and most confusing market. It splits into two parts that price very differently: ACA Marketplace plans, where a premium tax credit may cover a large share of the cost, and private carrier plans sold outside the Marketplace, where no subsidy exists but the underlying pricing and networks may be better.

Which one wins depends almost entirely on your income relative to the federal poverty level. It is a calculation, not a preference — and it is the first thing we run.

Individual & family coverage in detail · Check your subsidy eligibility

Self-employed and 1099

Contractors, freelancers, owner-operators, consultants, diplomats and government contractors. The common thread is variable income, which changes the subsidy math considerably and creates real risk at tax time if the estimate is wrong.

The other thread is portability. Coverage that works in one metro area is a liability if your work moves you around.

Self-employed, 1099 & entrepreneurs · Truck drivers & owner-operators

Small business and group

Group coverage for teams of two to fifty, plus the alternatives that often beat it: level-funded plans for healthy teams, and ICHRA for employers who want predictable spend. Sometimes the honest answer is that your people would do better buying individually with a raise — and we will say so.

Small business & group coverage

COBRA and transition coverage

When employer coverage ends you get an election window, and COBRA is the loudest option in the envelope. It is rarely the cheapest. Losing job-based coverage opens a special enrollment period, which means the individual market is available to you right then — often at a fraction of the COBRA premium.

The window is short and it does not reopen. This is the single most time-sensitive decision in health insurance.

COBRA alternatives

Every option here costs you the same to access. Carriers build advisor compensation into the premium whether you use an advisor or buy direct. Going it alone does not save you money — it just removes the person whose job is to compare.

What we add beyond the plan list

  • Network verification. We check that your doctors and prescriptions are actually covered before you enrol, not after.
  • The cost-sharing reduction check. Under 250% of the poverty level, Silver plans carry a lower deductible and out-of-pocket maximum at no extra premium. It is the most overlooked benefit in the Marketplace and invisible if you sort by price.
  • Enrollment and paperwork. Applications, documentation requests, effective dates.
  • The same advisor next year. Renewals, plan changes and claim questions go to the person who set it up.

Common questions

What are private plans not available online?

Health insurance products offered directly by carriers outside HealthCare.gov and the state marketplaces. They price differently, have different networks and different benefit structures. For a household that does not qualify for a subsidy, a private plan is frequently cheaper than the equivalent Marketplace plan — and nobody shopping HealthCare.gov alone will ever see it.

How do I know whether the Marketplace or a private plan is better for me?

It usually comes down to subsidy eligibility. If your income puts you comfortably under 400% of the federal poverty level, the Marketplace is almost always the better value because a tax credit covers part of the premium. Above that line, with the subsidy cliff back in 2026, private plans deserve a serious look. The subsidy calculator on this site will tell you which side of the line you are on.

Do you charge for the comparison?

No. Carriers compensate advisors when you enroll, and your premium is the same whether you use an advisor or not. The consultation, the comparison, the paperwork and the ongoing support cost you nothing extra.

Saintellus Health Advisory is an independent insurance agency licensed in 31+ states. Plan availability, pricing and eligibility vary by state, county, age and household. This page is general education and is not medical, tax or legal advice.

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Why the right plan matters

The right coverage keeps your life afloat.

Nobody buys health insurance for the policy document. You buy it so that a diagnosis, an accident or a bad month does not take everything else down with it — the house, the business, the savings you were putting toward something else.

That is the real test of a plan, and it is not the monthly premium. It is whether the thing holds when you finally need to reach for it.

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Mohab H. Saintelus
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