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You have health insurance available through your job. But maybe the premium feels expensive. Maybe adding your spouse and children costs significantly more. Or maybe you already have Marketplace coverage and just started a new job that offers benefits. So, can you simply decline your employer's insurance and keep, or enroll in, a Marketplace plan instead? Yes, you can buy Marketplace coverage even when an employer offers you health insurance. But there's a very important seco

It's that time of year again. If you have a Medicare Advantage or Medicare prescription drug plan, you should receive an important document from your insurance company this fall called an Annual Notice of Change, or ANOC. And while it may be tempting to add it to the pile of insurance mail on the counter, this is one piece of mail I don't want you to ignore. Why? Because your ANOC tells you what is changing with your current Medicare plan for next year. Even if you love your

When you're comparing health insurance plans, it's easy to focus on the monthly premium, deductible, copays, and whether your doctors are in-network. But if you take prescription medications, there's another part of your coverage that's just as important to check: The formulary. A formulary is simply the list of prescription medications covered by your insurance plan. And two health insurance plans that look very similar on the surface can cover the exact same prescription ve

One of the questions I'm asked from time to time is, "Why do you spend so much time explaining everything?" The answer is simple. Because I believe you should understand your insurance before you choose it. That may sound obvious, but unfortunately, that's not always how people experience the insurance process. Insurance Can Feel Overwhelming For many people, insurance is something they only think about a few times a year. Maybe it's during open enrollment. Maybe it's when th

One of the most common questions I hear from clients is: "Does my insurance cover this doctor?" It's a simple question, but the answer isn't always as straightforward as people expect. Just because your insurance covers a particular type of medical service doesn't necessarily mean it will cover every doctor or facility that provides that service. That's where provider networks come in. Understanding the difference between in-network and out-of-network care can help you avoid

That title probably sounds strange coming from an insurance broker. After all, isn't the goal of every appointment to enroll someone in a plan? Not necessarily. Over the years, I've had appointments where the best advice I could give someone was... "Keep what you have." Sometimes that's exactly the right answer. My Job Isn't to Sell You Something One of the biggest misconceptions about insurance is that every conversation ends with someone buying a policy. In my office, that'

You've left your doctor's office with a treatment plan, only to receive a call a few days later saying: "Your insurance requires prior authorization before we can move forward." If you've never heard the term before, it can be confusing—and frustrating. Many people assume their doctor has already decided they need the medication, procedure, or test, so why does the insurance company have to approve it too? Let's take a closer look at what prior authorization is, why it exists

When people ask how I got into the insurance industry, they're often surprised by the answer. I didn't grow up wanting to sell insurance. In fact, my career began in a completely different place. For more than eight years, I worked in operations and human resources, where one of my responsibilities was helping employees understand their benefits. Every year during open enrollment, I watched people try to make important decisions about their health insurance—often without trul

You open your mailbox and find a statement from your health insurance company showing hundreds—or even thousands—of dollars in medical charges. Your heart skips a beat. Before you panic, take a closer look. There's a good chance what you're holding isn't a bill at all. It's called an Explanation of Benefits, commonly referred to as an EOB. Understanding the difference between an EOB and a medical bill can save you unnecessary stress and help you better understand how your hea

When people compare health insurance options, the first number they usually look at is the monthly premium. That makes sense. Premiums are visible, easy to compare, and often the biggest number people see upfront. But when switching from an employer-sponsored health plan to an individual health insurance plan, the monthly premium is only one piece of the picture. In many situations, the real financial differences do not become obvious until medical care is actually needed. Em

Most people don’t spend much time thinking about how dental insurance calculates payments — until they receive a bill that is much higher than expected. At that point, terms like “MAC” and “UCR” suddenly appear on explanations of benefits, treatment estimates, or claim summaries, often without much explanation about what they actually mean or why they affect out-of-pocket costs. Understanding the difference between MAC and UCR reimbursement methods can make dental insurance m

One of the most frustrating moments for many patients happens after a dental procedure — when they receive a bill they thought insurance would fully cover. In many cases, the confusion starts with a very common assumption: “If my dental insurance says something is covered, that means I won’t owe much.” Unfortunately, dental insurance often does not work that way. Dental plans are typically designed to help share the cost of care, not eliminate it entirely. While that distinct

If you’ve ever looked at a dental explanation of benefits or bill and seen the term “UCR,” you’re not alone in wondering what it means. It’s one of those insurance terms that shows up frequently but rarely gets explained clearly. Unfortunately, it can also directly affect how much you pay out of pocket for dental care. UCR stands for Usual, Customary, and Reasonable. It’s a method some dental insurance plans use to determine how much they consider an acceptable charge for a p

Prescription drug coverage can be confusing and costly. Learn how tiers, copays, coinsurance, and formularies work — and how to avoid surprise bills.

Learn what to do when your doctor stops accepting your insurance. Get practical tips to confirm changes, explore options, and find a new in-network provider without stress.

An ICHRA works best when employees understand it. Discover why education and guidance are key to making this benefit truly effective.

ICHRAs offer flexibility and cost control for employers — but success depends on thoughtful design, clear communication, and proper employee support.

Not all ICHRAs benefit every employee equally. Learn how income, household size, and plan design affect whether an ICHRA is right for you.

Thinking about using an ICHRA while getting ACA premium tax credits? Discover why employees can’t use both and how it affects coverage choices.

Part 1: What Is an ICHRA? A Plain-English Explanation for Employers and Employees If you’ve heard the term ICHRA and thought, “I should probably understand this, but I don’t,” you’re not alone. ICHRAs are becoming more common, especially among small and growing businesses—but they work very differently from traditional group health insurance. Understanding what an ICHRA is (and what it isn’t) is the first step to knowing whether it makes sense for an employer or an employee.