Can’t afford a plan — and you don’t qualify for help?
Most people who land here are not trying to get something for nothing. They looked at the price of an Obamacare plan, looked at what they earn, and the two numbers did not meet.
Sometimes the subsidy is there and nobody checked properly. Sometimes it genuinely is not, and the honest conversation is about what else exists. Either way there are more options than the marketplace website shows you, and some of them are things almost nobody mentions. Here is the whole list, including the ones we do not sell.
Twelve questions, answered straight
Tap the one that sounds like you.
Is there a cheaper alternative to an Obamacare plan?
Mostly the honest answer is no — and the useful answer is that the cheapest thing available is usually still a marketplace plan you did not know you could buy.
When people search for an alternative to Obamacare they normally mean one of three things: they were told they get no subsidy and believe that is final, they have not heard of catastrophic plans or Covered Connecticut, or they are looking at a health share and want to know whether it is safe. All three are answered below.
There are things sold as alternatives that are not insurance at all. We will tell you plainly which is which, including the ones we do not sell.
I was told I earn too much for help. Is that actually true?
Often it is not, and it costs nothing to check properly. A surprising number of people are told once that they get no subsidy, believe it, and never check again.
The help is based on the income you expect next year, not the income you had last year. If your hours changed, a contract ended, a business had a bad year or a household split up, the number the marketplace is using may be wrong. Household size matters too, and so does whether a job offers you coverage — an offer at work only shuts the help off if the plan passes two specific tests, and plenty of people assume it does when it does not.
The premium tax credit — the subsidy — is recalculated every single year, on figures you supply. Bring them and we will run it with you. It takes a few minutes and it is free.
Can I change the income the help is based on?
Sometimes, yes — legally, and almost nobody tells you this one.
The income your help is calculated on is not simply what you are paid. Certain things come off it before the marketplace looks at it. Money you put into a health savings account is one of them. So is a self-employed retirement contribution, and so are some business expenses if you work for yourself.
For a household sitting a little over the line and getting nothing, that can be the difference between no help at all and real help. It does not work for everyone and it has to be done properly. It is worth twenty minutes with someone who will actually look.
What is Covered Connecticut, and could I be in it?
If you live in Connecticut, are between 19 and 64, and your household income is at or below 175% of the federal poverty level, you may qualify for no-cost health insurance — plus dental and rides to appointments — through the Covered Connecticut Program.
Two things people do not know about it. You can apply at any time of year — you do not need a life event and you do not need to wait for open enrollment. And you have to be enrolled in a Silver-level plan and using all the help you are entitled to, which is exactly the kind of detail that gets missed.
New Jersey and Pennsylvania do not have this same program, but each has its own rules about who gets help and how much. Ask and we will check yours.
Could I buy a catastrophic plan?
Possibly — and most people over thirty do not know this is open to them.
A catastrophic plan is real marketplace coverage. It covers the same essential benefits, it cannot turn you down for your health, and preventive care is still included. The premium is much lower and the deductible is much higher.
Under thirty, you can simply buy one. Thirty or over, you can buy one for 2027 if you get a hardship or affordability exemption certificate first. If a plan genuinely costs more than you can pay, that is the situation the exemption exists for.
The certificate takes paperwork and it is not instant. If this might be you, start now rather than in January.
What about a Bronze plan with a health savings account?
Worth a serious look, and it pairs with the question above.
Bronze and catastrophic marketplace plans are both eligible for a health savings account in 2027. Money going into that account is yours, it rolls over, and it can lower the income your help is figured on. So the same decision can cut your premium and improve your help at the same time.
What about health share plans? Are they worth it?
This comes up a lot this year, so here is the straight answer.
A health share is not insurance, and that is not a technicality. It is a group of people who agree to share each other’s medical costs. When it works, members are happy and it costs less than a plan.
Here is what you are giving up.
Nobody is legally required to pay your bill. If they decline, it is not a denied claim. There is no appeal, no state insurance department to complain to, and no guarantee fund behind it.
Pre-existing conditions are usually excluded, often for years, and prescriptions are frequently not covered at all — surveys find only about half of members know that. Many health shares also require a statement of faith or a commitment about how you live.
And in New Jersey there is still a state penalty for going without coverage. A health share does not automatically excuse you from it. You have to claim the exemption yourself, correctly, at tax time.
We do not sell these, and we are not going to talk you out of one either. For a healthy person who understands the deal, it can be a reasonable choice. For someone with a condition, or on regular medication, or who could not absorb a large unpaid bill, it is a serious gamble.
If you are considering one, bring it to us and we will go through it with you honestly — including whether something we do sell would cover you better for a similar amount.
What if I simply cannot buy a health plan this year?
Then the goal changes from covering everything to not being wiped out, and there are real products for that.
Hospital and accident coverage pays you a set amount when something specific happens — a night in hospital, a broken bone, a serious diagnosis. Dental and vision are sold separately and cost far less than people expect.
Be clear about what these are. They are not a substitute for a health plan and we will never tell you they are. They are a floor under you while you are exposed, and they are honest about it.
We write all of these in Connecticut, Massachusetts, New Jersey, Pennsylvania and South Carolina.
I already have bills I cannot pay. Is it too late?
No, and this is more fixable than people think. Hospitals have financial assistance programs they do not advertise, bills contain errors more often than they should, and amounts are negotiable far more often than people realize.
See what to do about a medical bill. That is a different conversation from this one, and we help with it either way.
What does it cost to ask?
Nothing, ever. We are paid by the insurance company when someone enrolls, and the plan costs you the same whether you use us or not. There is no fee at any point.
If the best answer turns out to be the plan you already have, or a program we are not paid for at all, we will tell you that. It is the whole reason people come back.
A job offers me coverage. Is that why I get nothing?
Maybe, and maybe not — this one has more give in it than people realise. An offer at work only shuts off the tax credit if the plan is affordable by the formula (your share of the cheapest self-only plan at or under 10.22% of household income for 2027) and it meets minimum value. Fail either and help is available. And your spouse and children are now tested separately from you, on what it costs to add them — which is how one household legitimately ends up with the worker on the plan at work and the family on a subsidised marketplace plan. The whole work-plan test, in plain words.
My renewal went up and I simply cannot pay the new number. Where do I start?
Start by finding out which of three things happened, because the fix is different for each. The temporary extra credit expired, so most people get less help than last year. Plan prices rose on their own. And anyone who crossed 400% of the federal poverty level now gets nothing rather than less. A surprising number of people in the first group believe they are in the third one and cancel before anybody checks. Why a 2027 premium went up, and what to check first.
The deadline is real
For coverage starting January 1 you need to be enrolled by December 15 in Connecticut and Pennsylvania, and by December 31 in New Jersey. Open enrollment itself runs to January 15 in Connecticut and Pennsylvania and to January 31 in New Jersey.
Call or text (860) 200-2272, or send a message. English or Spanish, and asking costs nothing.