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Types of Health Plans

Finding the right health insurance plan is easier once you understand the options that are available to you. During Open Enrollment, which is November 1, 2023 through January 15, 2024, you can enroll in an Obamacare/ACA plan – that is, a plan that meets minimum requirements as set forth by the Affordable Care Act.

Outside of the Open Enrollment period, you may be eligible to enroll in an Obamacare/ACA plan if you experience a qualifying life event, such as moving to a new state, having a baby, or getting married or divorced. This is called the Special Enrollment period, and lasts for 60 days after the date of your qualifying life event.

If you would like to enroll in a plan outside of the Open Enrollment period and you do not qualify for Special Enrollment, you can consider enrolling in an alternative plan, such as a short-term, limited/fixed indemnity, or critical illness plan. These types of plans typically do not cover preventative care, and are designed to protect you financially in the case of an accident or if you need serious medical care. You will have to pay out of pocket for most routine care with these types of plans.

Types of Obamacare Plans

All Obamacare/ACA plans are placed into four metal level categories, and all offer the exact same level of quality health care, with the difference being in premium and out-of-pocket cost ratios. All of these plans cover Ten Essential Health Benefits as set forth by the Affordable Care Act. These benefits include: 1) ambulatory care; 2) emergency services; 3) hospital coverage; 4) maternity and newborn care; 5) pediatric services (including dental and vision); 6) mental health and addiction treatment; 7) prescription drug benefits; 8) rehabilitative coverage; 9) laboratory services; and 10) preventative services and chronic disease management.

Plan Type
Medical Expenses You Pay (does
not include your premium)
Medical Expenses
the Plan Pays

Making a decision about which metal level plan you should choose involves thinking about your plan usage. If you plan to go to the doctor frequently, you will likely be better off choosing a plan with a higher premium and lower out-of-pocket costs as you will save money in the long run. On the other hand, if you don’t plan to go to the doctor frequently, you may save more by enrolling in a bronze or silver plan, where your monthly premiums are lower, but your out-of-pocket costs when you do go to the doctor are higher.

Individuals of certain income levels may also qualify for government assistance to pay for their insurance costs. The Premium Tax Credit is designed to help pay for monthly premiums, and Cost-Sharing Reductions help low income individuals pay for out-of-pocket costs.

Catastrophic plans are a fifth type of plan, but they are only available to individuals who meet eligibility requirements. Although they have the lowest monthly cost, the benefits are primarily limited to emergency situations, and you must meet certain eligibility requirements.

Plan Type
Out-of-Pocket Costs You Pay
How Much the Plan Pays
More than 40%
Less than 60%

To qualify for a Catastrophic plan, you must either be under the age of 30, or have a hardship exemption at any age. You may qualify for a hardship if you are experiencing:

  • Homelessness;
  • An eviction/foreclosure;
  • A notice of shutoff from your utility company;
  • Domestic violence or a death in the family;
  • A natural or man-made disaster.
  • Bankruptcy or substantial debt from medical expenses;
  • An increase in expenses due to caring for an ill, disabled, or aging family member;
  • Claiming a child as a tax dependent who was denied Medicaid or CHIP;
  • If you won an appeal for previously being denied a qualified health plan, but were denied eligibility at the time;
  • You lost coverage in the past, but found qualified health plans to be unaffordable;
  • Some other hardship related to obtaining health insurance.

Alternative Plans

Short-term Plans

Short-term insurance plans are an alternative option to ACA/Obamacare plans. But, they currently can only be purchased for short periods of time, and typically only cover catastrophic situations. If you have a short-term plan and need medical attention, you will have to pay out of pocket for any circumstances that are not considered catastrophic.

Still, short-term plans can be a good alternative for individuals who just want to be covered in case of emergency for short periods of time, or until they can enroll in an ACA/Obamacare plan.

Fixed or Limited Indemnity Plans

Fixed or limited indemnity plans are different from most insurance policies in that these types of plans will provide a specific cash pay-out to the policy holder if they incur an illness or injury that is outlined in the policy.

The idea behind fixed indemnity plans is to provide some financial protection against unexpected medical expenses.

Fixed indemnity plan benefits typically apply to a specific number of days, weeks, or visits and the amount remains the same regardless of the actual cost of those services. These plans are also sometimes referred to as hospital indemnity plans because they typically cover medical expenses resulting from hospitalization, surgery, chemotherapy and radiation services.

Critical Illness Plans

Critical illness insurance covers what the name says – critical illnesses. Typical illnesses this type of insurance covers include cancer, heart attack, stroke, and certain other illnesses that may vary based on the policy.

Because of the nature of this type of policy, which is designed to only cover serious illnesses, you will still have to pay out of pocket for treatment of any condition that is not described as a covered condition in the insurance policy. This means that any preventative care – such as regular doctor check-ups – or even urgent care treatment is not covered, and you will be responsible for paying out of pocket for the entirety of the cost.

To start comparing plans, please submit your zip code to begin the process. You can also call (855) 339-0012 to speak with an agent.

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Federal Contracting Statement: Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

TPMO Disclaimer: We do not offer every plan available in your area. Currently we represent [73] organizations which offer [5110] products in your area. Please contact or 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Please note that these numbers provided are not specific to your area but rather represent the number of organizations and the number of products available on a national basis. We will connect you with licensed insurance agents who can provide information about the number of organizations they represent and the number of products they offer in your service area.

Submitting this form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage plan, Medicare Prescription Drug plan, Medicare Supplement Plan, or any other Medicare plan. QuoteLab, LLC is independent of the Medicare program and is neither associated with nor endorsed by The Centers for Medicare & Medicaid Services (CMS) or any other governmental agency.

The plans represented on are Medicare Advantage HMO, PPO and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal. If you are paying Medicare Part B premium, you must continue to pay it to maintain coverage.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Every year, Medicare evaluates plans based on a 5-star rating system.

Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

Based on median Medicare Advantage benefit amounts for dental available across multiple plans and metro areas. Not all benefits available in specific plans or regions.

This information is not a complete description of benefits. Contact the plan for more information.

Limitations, copayments, and restrictions may apply.

[Benefits, premiums and/or copayments/coinsurance] may change on January 1 of each year.

Enrollment in a plan may be limited to certain times of the year unless you qualify for a special [election/enrollment] period or you are in your Medicare Initial Election Period.

Advertised Pricing:

There are several factors that impact your monthly premium; including your age, geographical location, annual income, dependents, and the type of plan you choose. Monthly premiums do not include out-of-pocket costs. is operated by QuoteLab, LLC, which is an independent broker and is not a federal or state insurance Marketplace or other website. It does not provide access to any federal or state marketplace or exchange. This website is owned and operated by QuoteLab, LLC, a licensed insurance agency, NPN #19911386. Invitations for application for health insurance are made through QuoteLab, LLC, only where licensed and appointed. License numbers are available upon request and are provided where required by law. QuoteLab's license information can be found at

This website does not provide information about specific health plans, or enable visitors to obtain insurance quotes, on this website. However, if you provide your information and consent, we will transfer your information to insurance carriers and brokers that may contact you to offer Affordable Care Act (ACA) plans, short-term plans, medical indemnity plans and/or healthcare sharing ministry plans, and we will receive compensation for such transfer. The advertisements appearing on this website are placed by clients from which QuoteLab, LLC receives compensation, and such compensation may impact whether such advertisements appear on this website and the order in which they appear. is required to comply with all applicable federal law, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website does not provide a complete listing of, or display all data on all Qualified Health Plans being offered in your state or service area through the Marketplace website or the federal Medicare program. To see all available data on Qualified Health Plan options in your state, visit your state Marketplace website, go to the Health Insurance Marketplace website at

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