Health Insurance FAQs to Guide Your Journey
Health insurance can feel like a maze—but you don’t have to figure it out alone. I’m Suzanne Wolf—Health Insurance Mom, based in Highlands Ranch, CO, and I’m here to help you sort through your options with care and clarity. Below you’ll find answers to some of the most common questions I hear from clients. If you don’t see your concern here, give me a call at (866) 870-9894—I’d be happy to walk through it with you.
What’s the Difference Between Marketplace and Private Insurance?
The Marketplace is where you can explore plans that may qualify for tax credits based on income. These plans are standardized but sometimes come with higher costs for those who don’t qualify for assistance. Private insurance includes a wider range of options—like dental, vision, accident, or critical illness coverage. The right choice depends on your health needs, income, and long-term goals.
How Do I Know If I Qualify for Financial Help?
Eligibility for tax credits depends on your household income and size. If your income falls within certain limits, you may receive financial assistance through the Marketplace. I’ll help you check eligibility and calculate what your monthly cost might look like with or without assistance. Many people are surprised to find they qualify for more help than they expected.
Can I Get Coverage Outside of Open Enrollment?
Yes—if you experience a qualifying life event. This includes losing other coverage, moving, getting married, having a baby, or turning 26 and aging off your parents’ plan. Private insurance also offers some flexibility outside of the federal open enrollment window. I’ll help you explore what’s available year-round so you don’t feel stuck without options.
Do You Offer More Than Just Health Insurance?
Absolutely. I can also help with:
• Dental and vision insurance.
• Life insurance.
• Accident insurance.
• Critical illness coverage.
• Wellness and preventive benefits.
Having these add-ons often makes a big difference. It means fewer surprises and more peace of mind for you and your family.
What If I Own a Small Business?
Small business owners have unique needs. If you have a team, I can help you explore group health plans, ICHRAs (Individual Coverage Health Reimbursement Arrangements), and supplemental benefits. I also work one-on-one with employees to make sure their individual needs are met—something most brokers don’t do.
If you’re self-employed with no employees, we can also look at individual plans that allow you to deduct premiums as a business expense. Either way, there’s a way forward.
Why Should I Work With a Health Insurance Advocate Instead of Going It Alone?
The truth is, you can shop for insurance on your own—but most people find it overwhelming. My role is to make the process simple, personal, and stress-free. I’ll explain everything in plain language, compare your options side by side, and give you advice as if you were family. That way, you can feel confident in your decision instead of second-guessing it.
What’s the First Step If I’m Feeling Overwhelmed?
Start by reaching out. We’ll have a simple conversation about your health needs, family situation, and budget. From there, I’ll guide you step by step so the process feels manageable instead of confusing.
What If I Have a Pre-Existing Condition?
This is one of the most common worries I hear. The good news is Marketplace plans cannot deny you for pre-existing conditions. That means if you’ve dealt with health challenges in the past—whether it’s diabetes, heart issues, or something else—you still have access to coverage.
Private plans may have different rules, but together we’ll look at your situation and find the path that makes sense. I’ll always be upfront with you so there are no surprises.
How Long Does the Enrollment Process Take?
For most people, the process is quicker than expected. Once we review your needs and select a plan, enrollment can often be completed in under an hour. The key is preparation—gathering your household information, income details, and any current coverage documents before we start.
My goal is to make it feel smooth and stress-free, so you leave the conversation feeling lighter instead of more confused.
When can I enroll in health insurance?
- November 1: Open Enrollment starts.
- December 15: Deadline to enroll coverage that starts January 1.
- January 15: Open Enrollment ends. Last day to enroll for coverage that starts February 1.
After January 15, you can only get a health plan if you qualify for a
Special Enrollment Period
(A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child).
Can I afford to leave a job that no longer suits me and get new benefits on my own?
ABSOLUTELY! There are many possible options to explore if you leave a job and want to either become self-employed or have time to look for something better.
My Spouse is retiring and we have always had benefits with their company. I am still too young for Medicare – can I find a plan for just myself?
Yes! It is a common occurrence to have to help one partner who is younger than the spouse that is retiring. There are several options to explore.
What do the following terms mean: Deductible, Coinsurance, and Maximum Out of Pocket?
Deductible – a fixed amount of money you must pay out of pocket before your health insurance plan starts to cover costs.
Coinsurance – The percentage that a patient pays after the deductible is met. The insurance company also pays a large percentage once the deductible is met.
Maximum Out of Pocket – Once the deductible and coinsurance have been met, the insurance plan will cover 100% of eligible healthcare costs for the remainder of the plan year.
Call me today at (866) 870-9894, and let’s make health insurance feel less overwhelming and more empowering.