Choosing health insurance often feels like trying to solve a puzzle where the pieces keep changing shape. As an independent broker, I see the same points of confusion every day. If you’ve ever felt overwhelmed by the jargon, you aren’t alone—but you might be paying more than you need to.

Let’s clear up the three biggest misconceptions so you can choose a plan that actually works for your life and your wallet. 

 

1. The Balancing Act: Premiums vs. Deductibles
The biggest mistake people make is looking only at the monthly premium (the “sticker price” to have the insurance). However, focusing solely on a low premium often leads to a sky-high deductible (the amount you pay out-of-pocket before the insurance kicks in).

• Low Premium / High Deductible: Great if you rarely see a doctor and want protection against ” catastrophic” events.
• High Premium / Low Deductible: Better if you have ongoing prescriptions or frequent office visits.

2. Why “Cheapest” Rarely Means “Best”
If a plan is significantly cheaper than the rest, it’s usually because it offers a narrower network or
limited benefits. A low-cost plan becomes the most expensive plan the moment you realize your
preferred surgeon is “out-of-network” or your specific medication isn’t covered. True value is found in the “Total Cost of Care”, not just the monthly bill.

3. Understanding Your Network
A PPO (Preferred Provider Organization) gives you the freedom to see specialists without a referral and often provides some coverage for out-of-network care. In contrast, an HMO (Health
Maintenance Organization) usually requires you to stay within a specific local network. Choosing the wrong one can lead to unexpected, full-price medical bills.

Finding the Right Fit for Your Stage of Life
Health insurance isn’t “one size fits all”. Depending on your age, employment status, and health, your best option might fall into one of these three categories:

Plan Type	Who It’s For	Key Features
Private & Supplement	Individuals & Families	Available year-round. Can cover 30 days to 36 months. Includes PPOs, Dental, Vision, and Critical Illness.
Medicare	Seniors (65+)	Choose between Medigap (to fill coverage gaps) or Medicare Advantage (all-in-one private alternatives).
ACA (Marketplace)	General Population	Best for those with pre-existing conditions. Enroll during Open Enrollment (Nov 1–Jan 15) or after a life event (marriage, baby, loss of insurance, etc).

Flexible Coverage for Different Needs
Private insurance and supplemental plans are the “Swiss Army Knives” of the industry. Because they are available at any time, they are perfect for people between jobs, entrepreneurs, or those who missed the ACA window. From accident and life insurance to cancer and final expense coverage, these plans can be tailored to fit a very specific budget. 

Need a Roadmap?

Navigating these options shouldn’t be a solo mission. I’m here to help you weigh the pros and cons of each path to ensure your family is protected without overpaying.

 

 

Great advice from Health to maximize your Vitamin D supplement.

Vitamin D is essential for overall health, including inflammation regulation, bone protection, and
regular sleep patterns. Taking vitamin D supplements can help raise low levels. 1  However, the time of day you take the supplement may affect its sleep benefits.

See the resources on The Conversation Project website.

National Healthcare Decisions Day exists to inspire, educate, and empower the public and
providers about the importance of advance care planning.

I encourage you to make decisions and to document your healthcare decisions. Here are some
resources to help you and to help you discuss the decisions with family and friends.

Amy Penna, in her article “Small business health insurance: The state of the market and what small businesses are doing about it”, states:

“You don’t have to look hard to find evidence that group health insurance has become prohibitively expensive for small businesses with fewer than 50 full-time employees. As we’ve reported in the past, annual group health insurance premiums in 2017 for small businesses were $6,486 for single coverage and $17,615 for family coverage. 

Additionally, traditional group health benefits come with other costs that can stretch a company’s budget. The cost to administer group health benefits adds up to over $12,000each year. With figures like these, it’s no wonder that the number of small businesses offering group health insurance has declined by 25 percent since 2010. Currently, less than half of small businesses offer any kind of health insurance to their workers.”  

Many small businesses would like to offer health insurance benefits but finding traditional group insurance is too expensive. There are alternatives solutions such as a taxable wage increase or tax-free personalized benefits (QSEHRA) and other options that benefit both the employer and the employee in these ways:

• The health insurance plan belongs to the employee and, in the event, the employee leaves employment, they are not without health insurance nor are they subject to the high cost of COBRA.
• The employee has more options to customize their health insurance to fit their needs and budget.
• The employer is not involved with the annual task of reviewing health insurance plan benefits. As one employer recently stated, “I can be out of the business of health insurance and not feel pressured on making the right plan options for my employees. I have also been the person they come to when they are not happy with their insurance. It is a great relief not to have to deal with those issues.”

The Taxable Wage Increase method increases employee’s wages so they can afford to purchase a health plan. On the company side, business owners don’t have to worry about playing middleman between the insurance company and their employees. On the other hand, the employee pays income tax on the increased wages. However, the premium can be lower than that of a group plan premium so the employee still comes out financially ahead and they have a health insurance plan customized to their needs.

The Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) also known as a small business HRA, is a company-funded, tax-free health benefit used to reimburse employees for personal health care expenses. The business must establish legal QSEHRA plan documents, including a summary plan description to comply with IRS and Department of Labor requirements.