If you’re shopping for individual or family marketplace health insurance, you might have dozens or even hundreds of options available. A lot of factors can go into finding the best fit for you. We’ll help you compare quotes based on premiums, coverage, out-of-pocket costs and more.
What you’ll need for a health insurance quote
You’ll need to provide some information about yourself, your family and your finances. Here’s a general sense of what you might need to get started:
Financial information:
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Number of people on your tax return.
Needed to see if you qualify for subsidies that lower your premiums and/or out-of-pocket costs.
Optional health information:
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Doctors (helps find plans with your providers in network).
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Medications (helps find plans with coverage for your prescription drugs).
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Health conditions (helps find plans with coverage for needed services).
If you want coverage for your spouse and/or dependents, you’ll need to provide information about them, too.
Where do I get health insurance quotes?
How you get health insurance quotes might depend on where you live and how you prefer to shop. Here are some options.
Most states use the federal marketplace at HealthCare.gov. Some states have their own health insurance marketplaces. If you start on HealthCare.gov, you’ll be sent to the right place based on your location.
On the marketplace, you can shop for plans, compare options and apply for coverage if you qualify.
If you want help finding a good option, you can work with a health insurance broker or agent.
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Brokers often sell plans from multiple companies. State law might require them to act in your best interest.
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Agents generally work for a single company.
Brokers and agents are paid by health insurance companies, so you don’t pay for their services.
Health insurance companies
You can also shop and sometimes enroll directly with some insurance companies.
As with insurance agents, you’ll only see the company’s plans on its website. You’ll have to go elsewhere to compare plans from multiple companies.
Depending on the company and state rules, you might need to complete some enrollment steps, such as checking your eligibility for subsidies, on the marketplace.
🤓Nerdy Tip
To qualify for premium tax credits and other savings, you need to enroll through a health insurance marketplace. But you can still use a certified agent, broker or company’s website to do so.
When is open enrollment for health insurance?
Your open enrollment period depends on where you live and whether your state uses the federal marketplace on HealthCare.gov or its own state marketplace.
HealthCare.gov
(Sign up by Dec. 15 for coverage starting in January).
State exchanges
Generally starts in November and ends in January.
A special enrollment period might allow you to sign up outside of open enrollment because of a qualifying life event. Examples include getting married or divorced, moving, having a child or losing other insurance coverage.
How to pick a marketplace health insurance plan
There can be a lot of moving parts when shopping for health insurance coverage. Here are a few questions to help you think through your needs and options:
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How much are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?
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Are you eligible for subsidies? Whether applying yourself or with an agent/broker, be sure to enter accurate information to check whether you’re eligible for subsidies through the marketplace.
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Is your doctor in-network? If you have a preferred doctor (or doctors) or hospital, make sure they participate in the plan’s network.
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Are your prescriptions covered? If you’re on medication, understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?
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Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?
If you have questions or need help navigating the marketplace, you can get help from a trained assister or an agent/broker at HealthCare.gov.
Compare types of health insurance
You might see different kinds of health insurance plans on the marketplace. They break down according to two major categories:
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Plan types: How the plan handles provider networks and/or authorization for services.
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Metal levels: How much of the cost of care the plan covers.
Health insurance plan types
Plan types can determine whether you need to stay in a certain provider network or get referrals for care. Here are examples of plan types you might see on the health insurance marketplace:
Health insurance metal levels
Marketplace health insurance plans come in four different metal levels: Bronze, Silver, Gold and Platinum. Each metal level covers different percentages of your health care.
Bronze and silver might have the lowest premiums, but they cover less of the total cost of care. As a result, your out-of-pocket costs might be higher. Gold and platinum plans typically have higher premiums but lower out-of-pocket costs.
Here’s how the metal levels compare:
Compare health insurance costs
Health insurance premiums can be expensive, so it’s a good idea to shop with price in mind.
It’s important to know that there are subsidies available to help cover some or all of the cost of marketplace plans, if you qualify. These subsidies can make certain plans much more affordable.
Premium tax credits
Premium tax credits can reduce what you pay for premiums. You can qualify based on income. In general, people with household income between 100% and 400% of the federal poverty line (FPL) can qualify.
For an individual in the contiguous U.S., that’s between $15,650 and $62,600 per year in 2025. For a family of four, the range between 100% and 400% of the FPL would be $32,150 to $128,600 per year.
Premium tax credits use a sliding scale with the largest subsidies for people with lower income.
The largest tax credits are equal to the cost of the second-cheapest Silver plan available to you. That could make some plans free to you or substantially reduce the cost of higher-priced options.
Cost-sharing reductions
There’s also help available to reduce copays, coinsurance and deductibles. If you qualify for premium tax credits and your income is up to 250% of the FPL, you might also qualify for cost-sharing reductions.
For an individual in the contiguous U.S., 250% of the FPL is $39,125 per year, for example. For a family of four, it’s $80,375 per year. (Alaska and Hawaii have their own slightly higher income limits.)
Similar to premium tax credits, people with lower income get larger cost-sharing reductions.
Note: Unlike premium tax credits, cost-sharing reductions only work with Silver plans. If you choose a different metal level, you can’t get cost-sharing reductions.
🤓Nerdy Tip
Visit HealthCare.gov or work with a licensed broker or agent to calculate your subsidies before you start comparing plans. That way, you can compare based on the price you’d actually pay.
Clinton Mora is a reporter for Trending Insurance News. He has previously worked for the Forbes. As a contributor to Trending Insurance News, Clinton covers emerging a wide range of property and casualty insurance related stories.