# The Insurance Guide

> The independent, honest guide to what health insurance really costs, including when not to buy. Every figure on the site traces to official data: CMS Marketplace public use files (plan year 2026), IRS Rev. Proc. 2025-25 applicable percentages, HHS federal poverty guidelines, and KFF benchmark premiums for state-based exchanges. Estimates are free and require no email.

- [Full content](https://theinsurance.guide/llms-full.txt)

## Tools

- [Calculator hub](https://theinsurance.guide/calculator): Free, independent calculators for 2026 health insurance built on official CMS data: estimate subsidies, compare COBRA vs marketplace, check your special enrollment window, and compare plans side by side.
- [Subsidy estimator](https://theinsurance.guide/calculator/subsidy-estimator): Enter your ZIP, ages, and income to see your estimated premium tax credit and what plans cost per month in your area. No email required.
- [COBRA vs marketplace](https://theinsurance.guide/calculator/cobra-vs-marketplace): Enter your COBRA premium and income to see which option costs less for the rest of 2026, and when keeping COBRA is the right call.
- [SEP deadline checker](https://theinsurance.guide/calculator/sep-checker): Enter your qualifying life event and date to see your special enrollment window, exact deadline, and what you will need to document.
- [Plan comparison](https://theinsurance.guide/calculator/compare-plans): Select up to three plans in your area and compare monthly premiums, deductibles, and out-of-pocket maximums side by side.
- [True cost of care](https://theinsurance.guide/calculator/total-cost-of-care): Enter your ZIP, ages, income, and how much care you expect, and see what each plan really costs over a year (premiums plus what you would pay toward care), with every plan in your area sorted cheapest first.
- [Metal tier recommender](https://theinsurance.guide/calculator/metal-tier-recommender): Answer four plain questions and add your ZIP, ages, and income to get a recommended metal tier (Bronze, Silver, or Gold) with the reasoning shown and the real true-annual-cost numbers to check it against.
- [FPL calculator](https://theinsurance.guide/calculator/fpl-calculator): Enter your income, household size, and state to see your income as a percentage of the federal poverty level, plus the exact dollar lines for Medicaid, subsidies, and the 400% subsidy cliff.
- [Am I overpaying](https://theinsurance.guide/calculator/am-i-overpaying): Enter what you pay now and the metal tier you’re on to see how your premium compares to the cheapest comparable plan after subsidy, including the honest verdict when you’re already paying a fair price.
- [HSA & FSA tax savings](https://theinsurance.guide/calculator/hsa-fsa-savings): Enter your contribution, income, and filing status to see the tax you keep by contributing pre-tax to an HSA or health FSA: the income tax, plus the FICA payroll tax on a paycheck-deducted HSA.
- [Coverage gap finder](https://theinsurance.guide/calculator/coverage-gap-finder): Answer seven quick questions and get a checklist of what to verify on a health plan, because ACA plans cover the ten essential benefits, so the real gaps are network, drug formulary, and adult dental and vision.
- [Embeddable widget](https://theinsurance.guide/embed): Add the free 2026 ACA subsidy calculator to any site with three lines of HTML: no API key, no account. The widget computes estimated premium tax credits and plan-tier price ranges for any ZIP code; income is used only in the visitor’s browser and never transmitted.

## Quizzes & self-assessments

- [Insurance IQ quiz](https://theinsurance.guide/quiz/insurance-iq): A free 10-question quiz on how health insurance actually works (deductibles, subsidies, COBRA, open enrollment, and more) with a short, sourced explanation after every question that links to the matching /learn glossary entry. No email, scored out of ten.
- [Coverage health score](https://theinsurance.guide/coverage-score): A free, transparent 0–100 self-assessment of how healthy your coverage is: answer a handful of questions, see exactly how each one moves your score in a full factor breakdown, and get links to the tools that fix what is weighing it down. A starting point, not a verdict.

## Agent tools (MCP)

- Endpoint: https://mcp.theinsurance.guide (streamable HTTP, no authentication required)
- estimate_subsidy: Estimate the 2026 ACA premium tax credit and marketplace plan prices for a household from ZIP code, ages, household size, and income.
- check_sep_window: Check whether a 2026 Special Enrollment Period window is open, upcoming, or closed for a qualifying life event, with the exact deadline, documents, and enrollment portal.
- compare_cobra: Compare the total cost of keeping COBRA against the best subsidized marketplace Silver plan over a chosen number of months, with an honest verdict.
- Server card: https://theinsurance.guide/.well-known/mcp/server-card.json

## Markdown

Content pages return markdown when requested with Accept: text/markdown.

## Guides (downloads)

- [The COBRA decision, three numbers (worksheet)](https://theinsurance.guide/guide/cobra-worksheet): Free COBRA vs marketplace decision worksheet for 2026: the three-number method (COBRA premium, subsidized estimate, deductible progress) with a comparison grid, the when-COBRA-wins checklist, and the two 60-day clocks.
- [Self-employed health coverage playbook](https://theinsurance.guide/guide/self-employed-playbook): Free self-employed health coverage playbook for 2026: honest income estimation, the section 162(l) deduction and its interaction with the subsidy, HSA pairing, and the quarterly re-estimation calendar.
- [Turning-26 coverage checklist](https://theinsurance.guide/guide/turning-26-checklist): Free turning-26 health insurance checklist for 2026: the deadline table, the 60-day special enrollment window, a six-step action checklist, the COBRA comparison, and a first-plan vocabulary box.
- [2026 subsidy income eligibility chart](https://theinsurance.guide/guide/subsidy-income-chart): Free 2026 subsidy income eligibility chart: annual income by household size against the poverty-level lines (100%, 138%, 150%, 250%, 400%) that decide Medicaid, cost-sharing reductions, and the premium tax credit, in dollars.
- [Employer vs. marketplace decision grid](https://theinsurance.guide/guide/employer-vs-marketplace): Free employer vs. marketplace decision grid for 2026: the fixed factors laid side by side (who pays the premium, subsidy eligibility, the affordability/offer rule that quietly decides eligibility), with when each side genuinely wins.
- [Denied claim appeal kit](https://theinsurance.guide/guide/appeal-kit): Free denied-claim appeal kit for 2026: the two appeal stages (internal review, then independent external review), the deadlines, who qualifies under federal law, and a fill-in appeal letter.
- [New parent coverage checklist](https://theinsurance.guide/guide/new-parent-checklist): Free new-parent coverage checklist for 2026: the 60-day special enrollment window that birth, adoption, or foster placement opens, the retroactive-to-the-event start date, the two enrollment paths, and what to do when.

## Learn (glossary + comparisons)

- [Learn hub](https://theinsurance.guide/learn): Plain-English definitions of the 63 health insurance terms that decide what you pay (deductible, coinsurance, out-of-pocket maximum, metal tiers, premium tax credit, HSA, FSA, and more), plus 22 side-by-side comparisons (PPO vs HMO, HSA vs FSA, bronze vs silver, copay vs coinsurance, COBRA vs marketplace, and others). Each entry is short, sourced, and links to a calculator.
- 63 glossary terms at /learn/[term] and 22 comparisons at /learn/[a]-vs-[b], all listed and linked from the hub.

## Articles (blog)

- [When to drop collision and comprehensive coverage: the 10% rule](https://theinsurance.guide/blog/when-to-drop-collision-and-comprehensive): Collision and comprehensive are worth real money on a newer car and a bad deal on an old one. Here's the simple math that tells you exactly when to drop them and pocket the premium instead.
- [Renters insurance with roommates: share a policy or get your own?](https://theinsurance.guide/blog/renters-insurance-with-roommates): You can technically add a roommate to one renters policy, but in almost every case, separate policies are cheaper, cleaner, and better protection. Here's why sharing usually backfires and when it's genuinely fine.
- [Life insurance riders explained: which ones are worth it](https://theinsurance.guide/blog/life-insurance-riders-explained): Riders are optional add-ons that customize a life insurance policy: some are genuinely valuable and often free, others are overpriced upsells. Here's a plain-English guide to the common ones and which actually earn their cost.
- [Life insurance rate classes and the medical exam, explained](https://theinsurance.guide/blog/life-insurance-rate-classes-medical-exam): The same $500,000 policy can cost one person half what it costs another, because of the rate class the insurer assigns after underwriting. Here's what the classes mean, what the medical exam checks, and how to land a better one.
- [Is a life insurance payout taxable? Usually not, but here's when it is](https://theinsurance.guide/blog/is-life-insurance-payout-taxable): The death benefit your beneficiaries receive is almost always income-tax-free. But interest, estate size, employer-paid coverage, and a little-known 'three-person' trap can each create a tax bill. Here's the full picture.
- [How to choose a life insurance beneficiary (and the mistakes that cost families)](https://theinsurance.guide/blog/how-to-choose-a-life-insurance-beneficiary): Naming a beneficiary is the step that decides who actually gets your death benefit, and getting it wrong can hand the money to an ex-spouse, trigger probate, or derail a child's benefits. Here's how to do it right.
- [How renters insurance liability actually works](https://theinsurance.guide/blog/how-renters-insurance-liability-works): Everyone buys renters insurance for their stuff, but the liability half is what protects your paycheck and savings if someone gets hurt or you damage the building. Here's what it covers, how much to carry, and where it stops.
- [How much does life insurance cost? What drives the price, and how to pay less](https://theinsurance.guide/blog/how-much-does-life-insurance-cost): Term life is far cheaper than most people think: often a small monthly cost for a healthy person in their 30s. Age, health, coverage amount, and term length drive the price. Here's what moves the number and how to lower it honestly.
- [How much does car insurance go up after an accident? What raises your rate, and for how long](https://theinsurance.guide/blog/how-much-does-car-insurance-go-up-after-an-accident): An at-fault accident can raise your premium meaningfully and stay on your record for years, but a not-at-fault claim, or one you pay out of pocket, may not. Here's what actually drives the increase and how to soften it.
- [How much car insurance liability do you actually need?](https://theinsurance.guide/blog/how-much-car-insurance-liability-do-you-need): State-minimum liability is the cheapest number on the quote and the one most likely to bankrupt you. Here's how to size your limits to what a crash could actually cost you, using your net worth, not the insurer's default.
- [Home insurance deductibles: the hidden hurricane and wind trap](https://theinsurance.guide/blog/home-insurance-deductibles-hurricane-wind): Your homeowners policy may have two deductibles: a flat dollar one for everyday claims and a percentage one for hurricanes or wind that can be many times larger. Here's how to read them and pick a deductible that fits your finances.
- [Full coverage vs. liability only: what 'full coverage' really means](https://theinsurance.guide/blog/full-coverage-vs-liability-only-car-insurance): 'Full coverage' isn't a real policy type: it's shorthand for liability plus collision and comprehensive. Here's what the label actually includes, and how to decide whether you need it.
- [Does renters insurance cover water damage? It depends where the water came from](https://theinsurance.guide/blog/does-renters-insurance-cover-water-damage): A burst pipe, an overflowing tub upstairs, a sewer backup, a flood: renters insurance treats each differently. Here's the line between what's covered and what isn't, and the cheap add-on that closes a common gap.
- [Does renters insurance cover theft from your car? The split-coverage rule](https://theinsurance.guide/blog/does-renters-insurance-cover-car-theft): If your laptop is stolen from your car, renters insurance covers the laptop, but not the broken window or anything built into the car. Here's how renters and auto insurance divide a car break-in.
- [Does homeowners insurance cover water damage? The sudden-vs-gradual rule](https://theinsurance.guide/blog/does-homeowners-insurance-cover-water-damage): Homeowners insurance covers water damage that's sudden and accidental (a burst pipe, an overflowing appliance) but not flooding, sewer backup, or slow leaks from neglect. Here's the line that decides whether your claim gets paid.
- [Does homeowners insurance cover roof replacement? The ACV settlement trap](https://theinsurance.guide/blog/does-homeowners-insurance-cover-roof-replacement): Whether your policy pays for a new roof, or a depreciated fraction of one, hinges on two words in your declarations: replacement cost or actual cash value. Here's how roof claims really pay, and why an aging roof gets less.
- [Does homeowners insurance cover dog bites? Usually yes, with important exceptions](https://theinsurance.guide/blog/does-homeowners-insurance-cover-dog-bites): Your homeowners liability coverage typically pays if your dog bites someone, even away from home. But breed exclusions, prior-bite history, and liability limits can leave you exposed. Here's how it works and how to protect yourself.
- [Does car insurance cover rental cars? What you already have, and what you don't](https://theinsurance.guide/blog/does-car-insurance-cover-rental-cars): Your own auto policy usually follows you into a rental car in the U.S., but only up to your existing limits, and it won't replace the rental company's lost income or diminished value. Here's what's covered, what isn't, and when to skip the counter upsell.
- [Do you need uninsured/underinsured motorist coverage?](https://theinsurance.guide/blog/do-you-need-uninsured-motorist-coverage): Roughly one in seven US drivers has no insurance, and many more carry the bare state minimum. Uninsured/underinsured motorist coverage is the piece that protects you when they hit you. Here's how it works and who needs it.
- [Do you need gap insurance? The new-car loan trap](https://theinsurance.guide/blog/do-you-need-gap-insurance): A new car can be worth thousands less than you owe the day you drive it off the lot. Gap insurance covers that difference if it's totaled. Here's who actually needs it and who is wasting money.
- [Do you need flood insurance? The gap your home policy leaves](https://theinsurance.guide/blog/do-you-need-flood-insurance): Standard homeowners insurance excludes flood: every policy, everywhere. Here's who actually needs a separate flood policy, why the FEMA map isn't the whole story, and how to decide even outside a high-risk zone.
- [How car insurance deductibles work, and how to choose one](https://theinsurance.guide/blog/car-insurance-deductibles-how-to-choose): Your deductible is the one number on your policy you control directly, and it's a straight trade between a lower premium and a bigger out-of-pocket hit at claim time. Here's how to pick the right one.
- [Actual cash value vs. replacement cost on renters insurance](https://theinsurance.guide/blog/actual-cash-value-vs-replacement-cost-renters): The single setting that decides whether a theft or fire claim pays enough to actually replace your stuff, or pennies on the dollar after depreciation. Here's the difference and why it's worth the small premium.
- [What renters insurance covers, and 6 things it doesn't](https://theinsurance.guide/blog/what-renters-insurance-does-not-cover): Renters insurance is cheap and broad, but it has hard edges people only discover at claim time: floods, roommates, pricey jewelry, and your business gear. Here's exactly where the policy stops.
- [Is renters insurance worth it? What a few dollars a month actually buys](https://theinsurance.guide/blog/is-renters-insurance-worth-it): Renters insurance is so cheap that people question whether it does anything. It does: it replaces your belongings, covers you if someone's hurt in your place, and pays your living costs if you're displaced. Here's the honest value case, and the rare times you can skip it.
- [How much renters insurance do you actually need?](https://theinsurance.guide/blog/how-much-renters-insurance-do-you-need): Renters insurance costs a few dollars a month, and most people size it by guessing, then discover their stuff is worth two or three times their limit. Here's how to set personal-property, liability, and loss-of-use coverage on purpose.
- [What homeowners insurance doesn't cover: flood, earthquake, and the gaps that surprise people](https://theinsurance.guide/blog/what-homeowners-insurance-does-not-cover): A homeowners policy covers a lot, but the exclusions are exactly the disasters people assume are included. Here are the big gaps (flood, earthquake, sewer backup, and more) and how to close the ones that apply to you.
- [Replacement cost vs. market value: the homeowners insurance mistake that leaves you underinsured](https://theinsurance.guide/blog/replacement-cost-vs-market-value-home-insurance): The most common homeowners insurance error is insuring your house for what it's worth on the market instead of what it costs to rebuild. Here's why those are different numbers, and how a coinsurance clause can shrink even a small claim if you get it wrong.
- [How much liability coverage do you need on your home, and when to add an umbrella](https://theinsurance.guide/blog/how-much-home-liability-insurance-umbrella): The liability side of your homeowners policy is the part that protects your savings from a lawsuit, and it's the coverage people pay the least attention to. Here's how to size it and when a personal umbrella policy becomes the smart, cheap next step.
- [Term vs. whole life insurance: how much you need and which to buy](https://theinsurance.guide/blog/term-vs-whole-life-insurance): Life insurance is one of the most oversold products in personal finance. Here's the honest version: size your coverage with the DIME method, buy term for almost every situation, and understand the narrow cases where permanent life actually fits.
- [How long should your term life insurance be? Choosing a 10, 20, or 30-year policy](https://theinsurance.guide/blog/term-life-insurance-length-10-20-30-year): Once you know how much term life to buy, the next question is how long. The right length is the number of years your family stays financially dependent on you. Here's how to figure that out and why longer isn't always better.
- [Do you actually need life insurance? Who needs it and who doesn't](https://theinsurance.guide/blog/do-you-need-life-insurance): The insurance industry's answer is always yes. The honest answer is: only if someone would suffer financially without your income. Here's a clear test for whether you need coverage at all, before you spend a dollar on it.
- [Why are health insurance premiums so high in 2026? And practical ways to cut your costs](https://theinsurance.guide/blog/why-are-health-insurance-premiums-so-high-2026): Marketplace premiums feel brutal in 2026 mostly because the enhanced subsidies expired at the end of 2025, so the 400% income cliff is back and the amount you pay after the subsidy jumped, on top of normal medical-cost inflation. Here's what's driving it and a step-by-step playbook to get your real cost back down.
- [When is Open Enrollment for 2026, and what to do if you miss it](https://theinsurance.guide/blog/when-is-open-enrollment-2026): Open Enrollment for 2026 coverage ran November 1, 2025 through January 15, 2026 on HealthCare.gov. The next window (for 2027 coverage) is shorter, November 1 to December 15, 2026. Here are the exact dates, when coverage starts, and the ways you can still enroll right now if you're reading this in between.
- [What does health insurance actually cover? Preventive care, prescriptions, mental health, and more](https://theinsurance.guide/blog/what-does-health-insurance-cover): Every plan sold on the ACA marketplace has to cover ten Essential Health Benefits: hospital stays, prescriptions, maternity, mental health, and free preventive care among them. Here's what 'covered' really includes, what it leaves out, and why covered almost never means free.
- [Turning 26: what to do when you age off your parents' health insurance](https://theinsurance.guide/blog/turning-26-aging-off-parents-health-insurance): Turning 26 doesn't end your coverage on your birthday: the real deadline depends on whether your parent has a Marketplace plan or a job-based one. Here's when your coverage actually ends, the 60-day window you get, how to switch with no gap, and the option that's usually cheapest now that you're a household of one.
- [Pregnancy and health insurance: coverage, costs, and how to enroll](https://theinsurance.guide/blog/pregnancy-and-health-insurance): Every ACA marketplace plan and most job-based plans cover maternity and newborn care: it's one of the ten essential health benefits, and pregnancy can never be treated as a pre-existing condition. Here's what's covered, what delivery actually costs you, and the enrollment rule that trips up pregnant people who don't already have coverage.
- [Out-of-pocket maximum vs. deductible: what's the difference?](https://theinsurance.guide/blog/out-of-pocket-maximum-vs-deductible): Your deductible is the starting line, what you pay before the plan helps. Your out-of-pocket maximum is the finish line, the most you can ever pay in a year. Mixing them up is how people pick the wrong plan and lose thousands. Here's exactly how the money flows, with the numbers.
- [Moving to a new state? What happens to your health insurance](https://theinsurance.guide/blog/moving-to-a-new-state-health-insurance): A permanent move out of your plan's service area opens a 60-day Special Enrollment Period to pick a new plan in your new state, but only if you already had coverage, and the new plan won't start until the first of a month, so a careless move leaves a gap. Here's how to sequence it, the prior-coverage rule that gets people denied, why your old plan and your Medicaid don't follow you, and what changes by state.
- [Is a high-deductible health plan (HDHP) right for you? Pros, cons, and real examples](https://theinsurance.guide/blog/is-a-high-deductible-health-plan-right-for-you): A high-deductible health plan is the right call if you're generally healthy, can cover the deductible in a bad year, and will actually fund the Health Savings Account it lets you open: the HSA's triple tax break is the whole point. It's the wrong call if you have a chronic condition, a surgery or baby on the calendar, or you won't fund the HSA, in which case you've just bought a high deductible with no upside. Here's how to tell which one you are, with real numbers.
- [How to sign up for health insurance: a step-by-step guide for first-timers](https://theinsurance.guide/blog/how-to-sign-up-for-health-insurance-step-by-step): Signing up for your own health insurance for the first time comes down to a window, a website, and about an hour. Here's exactly when you can enroll, what to gather before you start, and how to compare plans without getting burned by a cheap premium.
- [How to read your Summary of Benefits and Coverage (without getting lost)](https://theinsurance.guide/blog/how-to-read-summary-of-benefits-and-coverage): Every health plan must give you a Summary of Benefits and Coverage: a short, standardized document that shows the real cost-sharing behind the marketing. Here's how to read every section, from the deductible box at the top to the coverage examples at the bottom, and how to use two SBCs to compare plans line by line.
- [How to compare health insurance plans online: a step-by-step checklist](https://theinsurance.guide/blog/how-to-compare-health-insurance-plans-checklist): The cheapest premium is almost never the cheapest plan. Here's how to compare health insurance plans on HealthCare.gov or your state exchange the right way: starting with your subsidy, judging plans on total yearly cost, and confirming your doctors, hospitals, and prescriptions before you enroll.
- [How to add a spouse to your health insurance after marriage](https://theinsurance.guide/blog/how-to-add-a-spouse-to-health-insurance): Getting married opens a 60-day window to add your spouse to coverage or pick a new plan together, but only if at least one of you already had insurance, and the coverage doesn't start on your wedding day. Here's exactly how to do it, the prior-coverage rule that gets people denied, and how marriage quietly changes your subsidy.
- [How to add a new baby to your health insurance (and your newborn to Medicaid)](https://theinsurance.guide/blog/how-to-add-a-new-baby-to-health-insurance): A birth, adoption, or foster placement gives you 60 days to add your baby to coverage, and the coverage can start the day they were born. Here's exactly how to do it, the mistake that costs new parents the most, and how the rules shift state by state.
- [How much does health insurance cost per month in 2026?](https://theinsurance.guide/blog/how-much-does-health-insurance-cost-per-month-2026): There's no single number, and the sticker price is almost never what you actually pay. After the premium tax credit, most marketplace enrollees pay far less than the list price. Here's what drives your monthly cost in 2026, why the subsidy split matters more than any average, and how to get your real number in two minutes.
- [HMO vs PPO vs EPO vs POS: which health plan type should you choose?](https://theinsurance.guide/blog/hmo-vs-ppo-vs-epo-vs-pos-plan-types): The four plan-type letters come down to two questions: do you need referrals, and does the plan pay anything out of network. HMO is cheapest and strictest, PPO is the most flexible and priciest, EPO and POS sit in between. Here's how each one actually works, how to pick, and the single check that matters more than the letters.
- [Health insurance scams and red flags: how to spot junk plans and fake offers](https://theinsurance.guide/blog/health-insurance-scams-red-flags-junk-plans): A real ACA health plan never costs suspiciously little for 'comprehensive' coverage, never asks health questions, and is never sold by a same-day robocall. Here are the red flags of a junk plan and a scam, what real coverage actually guarantees, and how to buy safely straight from HealthCare.gov or your state marketplace.
- [Health insurance for freelancers, gig workers, and small business owners](https://theinsurance.guide/blog/health-insurance-for-freelancers-gig-workers): With no employer plan, the ACA marketplace is your main path to health insurance, and you don't need an LLC or a business license to use it. Here's how the premium tax credit works when your income is lumpy, the self-employed deduction that stacks on top, when to pair an HSA, and when Medicaid is the better answer.
- [Health insurance options if you lose your job: COBRA vs Marketplace vs Medicaid](https://theinsurance.guide/blog/health-insurance-after-losing-your-job-cobra-marketplace-medicaid): Losing job-based coverage opens a 60-day Special Enrollment Period: you don't wait for Open Enrollment. Here's COBRA vs a Marketplace plan vs Medicaid compared honestly: what each really costs, when COBRA is worth its full price, and how losing income often means a bigger subsidy or free coverage.
- [Employer plan vs. Marketplace plan: which gives you better value?](https://theinsurance.guide/blog/employer-plan-vs-marketplace-plan): If your job offers health insurance, one rule usually decides which is the better deal, taking it or shopping the Marketplace: whether the IRS considers your work offer 'affordable.' Here's how each side actually costs out, why an affordable employer offer blocks your subsidy, the family-glitch fix that can still rescue your spouse and kids, and when the Marketplace genuinely wins.
- [Does your health insurance cover telehealth and online doctor visits?](https://theinsurance.guide/blog/does-health-insurance-cover-telehealth): Almost certainly yes: most marketplace and employer plans cover telehealth, but 'covered' isn't 'free,' and the price varies a lot by plan. Here's how the cost works, what virtual care is genuinely good for, where it falls short, and the one HSA rule that just changed in your favor.
- [Do I qualify for a health insurance subsidy? 2026 income limits explained](https://theinsurance.guide/blog/do-i-qualify-for-a-health-insurance-subsidy-2026): You likely qualify for a 2026 marketplace subsidy if your household income lands between 100% and 400% of the federal poverty level (roughly $15,650 to $62,600 for one person) and you don't have an affordable job-based offer. Here's exactly where the lines fall by household size, what income counts, and what to do if you're near the cliff.
- [Deductible vs premium: which matters more when you choose a health plan?](https://theinsurance.guide/blog/deductible-vs-premium-which-matters-more): Your premium is what you pay every month to keep the plan; your deductible is what you pay when you actually use it. Neither 'matters more' on its own; they're a trade-off, and a low premium almost always rides on a high deductible. The honest way to choose is to compare each plan's worst case: a full year of premiums plus the out-of-pocket maximum. Here's how, with real dollars.
- [Common health insurance exclusions that surprise people later](https://theinsurance.guide/blog/common-health-insurance-exclusions): The bills that blindside people usually aren't from things their plan flat-out excludes: they're from out-of-network care, drugs off the formulary, services that needed prior authorization, and 'junk' plans that quietly leave out the big stuff. Here's what tends to be excluded, what's actually a denial you can fight, and how to check before it costs you.
- [Bronze vs Silver vs Gold: which metal tier is right for you?](https://theinsurance.guide/blog/bronze-vs-silver-vs-gold-metal-tiers): The metal tier isn't a quality rating. It's how the plan splits costs with you. Bronze means a low premium and a high deductible; Gold flips it; Silver hides a trick that can make it the cheapest real coverage if your income qualifies. Here's how to pick the tier that costs you the least over a full year, not the one with the prettiest name.
- [The benefits of buying health insurance through a licensed agent](https://theinsurance.guide/blog/benefits-of-using-a-licensed-health-insurance-agent): A licensed agent costs you nothing extra: their commission is already baked into the premium, the same price you'd pay buying direct. Here's what that built-in help actually gets you: a plan matched to your doctors and drugs, every subsidy you're owed, and someone to call when a claim goes wrong.

## State guides

- [Losing job coverage: state guides](https://theinsurance.guide/enroll/lost-job/texas): Losing job coverage opens a 60-day special enrollment window in Texas. Most people qualify for a subsidy. See your real 2026 cost. 51 state pages at /enroll/lost-job/[state].
- [Turning 26: state guides](https://theinsurance.guide/enroll/turning-26/texas): Aging off a parent's plan opens a 60-day special enrollment window in Texas. Most people qualify for a subsidy. See your real 2026 cost. 51 state pages at /enroll/turning-26/[state].
- [Moving: state guides](https://theinsurance.guide/enroll/moving/texas): Moving to Texas can open a 60-day special enrollment window, if you had coverage before the move. See your real 2026 cost. 51 state pages at /enroll/moving/[state].
- [New baby: state guides](https://theinsurance.guide/enroll/new-baby/texas): Having a baby opens a 60-day special enrollment window in Texas. Coverage can start retroactively on the birth date. See your real 2026 cost. 51 state pages at /enroll/new-baby/[state].
- [Getting married: state guides](https://theinsurance.guide/enroll/marriage/texas): Getting married opens a 60-day special enrollment window in Texas, if you or your spouse had prior coverage. See your real 2026 cost. 51 state pages at /enroll/marriage/[state].
- [Self-employed: state guides](https://theinsurance.guide/health-insurance/self-employed/california): Premiums, subsidy math on 1099 income, and the self-employed health insurance deduction, state by state. 51 state pages at /health-insurance/self-employed/[state].

## Data provenance

- CMS Marketplace public use files, plan year 2026 (filed plan and rate data behind HealthCare.gov)
- IRS Rev. Proc. 2025-25 (2026 applicable percentage table for the premium tax credit)
- HHS federal poverty guidelines (2025, used for 2026 coverage-year eligibility)
- KFF average benchmark premiums (state-based-exchange states where the PUF has no data)

## Contact

- privacy@theinsurance.guide