Who it's for
- Self-employed people and small-business owners
- Early retirees who aren't yet eligible for Medicare
- Families who don't have coverage through work
- People losing employer coverage after a job change
What it covers
- Doctor visits, hospital care and emergency services
- Prescription drugs
- Preventive care such as screenings and vaccines, often at no cost
- Mental health, maternity and the other essential health benefits required on ACA-compliant plans
Your options before Medicare
Most people under 65 who don't get insurance through an employer buy an individual or family plan. In Louisiana, that often means a plan through the Health Insurance Marketplace created by the Affordable Care Act, where plans are grouped into metal levels such as Bronze, Silver and Gold based on how you and the plan share costs.
Depending on your household income, you may qualify for a premium tax credit that lowers your monthly payment, and some Silver plans come with extra savings on deductibles and copays.
When you can enroll
Marketplace plans have an Open Enrollment Period each year that begins November 1. Outside that window, you generally need a qualifying life event — such as losing other coverage, moving, getting married or having a baby — to get a Special Enrollment Period. Special Enrollment windows are usually 60 days, so it's best to act soon after a change.
Understanding plan types
Individual plans come with different network types. HMOs and EPOs usually cover care only from in-network providers, except in emergencies, while PPOs also pay something toward out-of-network care. A plan with a lower premium often has a higher deductible, so we look at what you're likely to spend over a full year — not just the monthly price.
If you take regular prescriptions or see specialists, those details can change which plan is the better deal. We'll check them for every plan we compare.
What we compare for you
- Whether your doctors and hospitals are in network
- Your prescriptions and how each plan covers them
- The premium after any tax credit you qualify for
- Deductibles, copays and the out-of-pocket maximum
Turning 65 soon?
Your Initial Enrollment Period for Medicare starts three months before the month you turn 65. If you have an individual plan, plan the switch to Medicare carefully so there's no gap and you don't keep paying for coverage you no longer need. We help with the whole transition — from choosing between Medicare Advantage and a Medicare Supplement to picking a drug plan.
How we help
We'll listen to what matters most to you, explain your options in plain language, and help you enroll. If one person in your household has Medicare and another doesn't, we can help the whole family in one conversation.
Common questions about Health Insurance (Under 65)
Can I buy health insurance outside Open Enrollment?
Usually only if you have a qualifying life event, such as losing job-based coverage, moving or a change in household size. We can help you check whether you qualify for a Special Enrollment Period.
Will I qualify for lower premiums?
It depends on your household income and size. Many people qualify for a premium tax credit. We'll help you estimate your savings.
I'm under 65 and have Medicare because of a disability. Can you help?
Yes. You have Medicare options too, including Medicare Advantage and Part D plans. Medicare Supplement options for people under 65 can be more limited, so let's talk through your situation.
Do you charge for help with health insurance?
No. There's no fee for our help; we're paid by the insurance companies.
