Who it's for
- People without job-based coverage, including early retirees under 65
- Part-time, contract, and gig workers
- Anyone between jobs or whose employer coverage is ending
- People who want to compare their current plan against other options
How it works
An individual plan is a policy you buy for yourself (or your household) instead of getting it through a job. You pay a monthly premium to the carrier, and in return the plan shares the cost of covered care according to its deductible, copays, coinsurance, and out-of-pocket maximum.
Most people shop for ACA-compliant individual plans, either through the Health Insurance Marketplace or directly from a carrier. Through the Marketplace you can apply for a premium tax credit based on your expected household income. Buying directly from a carrier gives you the same type of ACA plan, but without income-based savings.
Once you pick a plan and pay the first premium, coverage starts on the plan's effective date. Your plan renews each year, and every fall you can keep it, switch, or update your income and household details.
What it covers
Plans that meet Affordable Care Act standards cover the essential health benefits, including:
- Preventive care, doctor visits, and outpatient services
- Emergency services and hospitalization
- Prescription drugs
- Maternity and newborn care
- Mental health and substance use services
- Lab work, rehabilitation services, and pediatric services, including children's dental and vision
What affects the cost
Prices aren't one-size-fits-all. These factors usually make the biggest difference:
- Your age (ACA rules limit how much more older adults can be charged)
- Where you live, down to your county and ZIP code
- Tobacco use, which can raise premiums in many states
- Who is on the plan (just you, you and a spouse, or a whole family)
- The metal level and network type you choose
- Household income, which determines any premium tax credit or cost-sharing reduction
ACA-compliant plans can't charge you more because of your health history or a pre-existing condition. Look at the total yearly picture, not just the monthly premium: the deductible, copays, and out-of-pocket maximum matter just as much when you actually use care.
When you can enroll
You can enroll during the annual Open Enrollment Period. For 2027 coverage, Open Enrollment runs November 1, 2026 through January 15, 2027. Choose a plan by December 15, 2026 for coverage that starts January 1; plans chosen December 16 through January 15 generally start February 1. Outside that window you generally need a Special Enrollment Period, which usually lasts 60 days after a qualifying life event such as losing job-based coverage, moving, getting married, or having a baby.
Key things to know
On-Marketplace vs. off-Marketplace
ACA-compliant plans can be bought through the Health Insurance Marketplace (where income-based savings are available) or directly from a carrier. Hollen can show you both.
Metal levels describe cost sharing, not quality
Bronze, Silver, Gold, and Platinum plans split costs differently. Lower-premium plans usually have higher out-of-pocket costs when you get care, and vice versa.
Network type changes how you get care
HMOs and EPOs usually require you to use in-network providers. PPOs typically offer some out-of-network coverage at a higher cost. Always check your doctors and prescriptions.
Know your key cost terms
Premium (what you pay each month), deductible (what you pay before the plan starts sharing costs for many services), copays and coinsurance, and the out-of-pocket maximum.
Timing matters
You can generally enroll during the annual Open Enrollment Period, or outside it if you have a qualifying life event such as losing other coverage, moving, marriage, or having a baby.
Common mistakes to avoid
- Choosing on premium alone and being surprised by a high deductible
- Not checking that your doctors, hospitals, and prescriptions are in network
- Underestimating or overestimating income on a Marketplace application
- Letting a plan auto-renew without reviewing next year's changes
- Buying a non-ACA plan without realizing it may exclude pre-existing conditions
How Hollen helps
Hollen asks about the doctors you want to keep, the prescriptions you take, and how often you expect to use care, then lays out plans from multiple carriers side by side. She explains the trade-offs in plain English, helps with the application, and checks in at Open Enrollment so your plan keeps fitting as your life changes.
Frequently asked questions
Can I be turned down because of a pre-existing condition?
ACA-compliant individual plans can't deny coverage or charge you more because of a pre-existing condition. Some other types of plans, like short-term medical, can, so it's important to know what you're buying.
What's the difference between 'private' and 'Marketplace' insurance?
Marketplace plans are private insurance plans offered by private carriers. The Marketplace is simply where you can compare them and apply for income-based savings.
Can I keep my doctor?
Possibly. It depends on whether your doctor is in the plan's network. Hollen can help you check specific doctors and prescriptions before you choose.
Is there a cost to use Hollen as my broker?
No. There's no extra charge to work with Hollen. Brokers are generally paid by the insurance carrier, and Marketplace premiums are the same whether or not you use a broker.
When does individual coverage start?
It depends on when you enroll. During Open Enrollment, a plan chosen by December 15 generally starts January 1. With a Special Enrollment Period, coverage often starts the first of the following month.
Related coverage
Family Health Insurance Plans · Affordable Care Act (ACA) Plans · Self-Employed Health Insurance Plans · Short Term Medical · Dental Insurance Plans
Hollen is licensed in 14 states. See coverage details for South Carolina, North Carolina, Georgia, Texas, Florida, or all licensed states.
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Get a free quote or book a time to talk it through with Hollen. “I work for you, not the insurance companies.”
This page is general educational information, not a guarantee of coverage, eligibility, or cost. Benefits, availability, and rules vary by plan, carrier, and state. Contact Hollen for details on specific plans.