Master FAQ.
Have questions about Medicare, ACA, group health, or life insurance? We’ve organized all of our most common FAQs in one place.
Click a category below to jump straight to the answers.
Table of Contents:
Medicare
Individual / Family Health Plans
Group Benefits
Medicare Basics
Learn more on our Medicare Basics page
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Part A (Hospital Insurance): Covers hospital stays, skilled nursing, hospice, and some home health.
Part B (Medicare Insurance): Covers doctor visits, outpatient care, preventive services, and durable medical equipment.
Part C (Medicare Advantage): Private plans that bundle Part A, Part B, often Part D, and may include extras like dental and vision.
Medicare Advantage can unfairly get a bad rap, but depending on location and needs, can be exactly what you need.
Part D (Prescription Drug Coverage): Helps pay for medications.
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Original Medicare (Parts A & B) does not cover:
Dental, vision, or hearing
Long term care
Most prescription drugs
Routine foot care, cosmetic surgery, or overseas care
Many people add a Medigap, Medicare Advantage, or ancillary plans to fill these gaps.
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Most people should enroll during their Initial Enrollment Period, a 7 month window around their 65th birthday. If you miss it, you may face penalties unless you qualify for a Special Enrollment Period.
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No. While most people pay $0 for Part A, Part B comes with a monthly premium, and additional coverage (Part D, Advantage, Medigap) also has costs. The right combination of plans help keep your out of pocket expenses predictable.
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Yes. Many people delay Medicare Part B if they still have employer coverage. The rules depend on your company size and benefits, so it’s important to review your situation before making a decision
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100%. Either Medigap, Advantage, and/or Part D depending on your needs and budget. If you don’t you’re billed at 20% for everything under Original Medicare, with no yearly cap.
Medicare Advantage (Part C)
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Sort of. When you join a Medicare Advantage plan, you still have Original Medicare, but your coverage is provided by a private insurer approved by Medicare, with Original Medicare being secondary.
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Private plans that bundle Part A, B, and usually D, often with extras like dental, vision, and hearing.
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Most do, but not all. Always check the plan details to confirm.
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It depends. Advantage plans often have lower premiums but can mean higher out of pocket costs. Medigap has higher premiums but offers predictable costs and nationwide access.
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They can depending on your home residence. Many use HMO or PPO Networks. That means you’ll usually need to see in network providers for the best pricing.
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You sure can. During Annual Enrollment (October 15 - December 7) or Open Enrollment (January 1 - March 31).
Explore details on Medicare Advantage
Medicare Supplement (Medigap)
See our Supplement page
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Medicare Supplement, aka Medigap, policies fill the “gaps” in Original Medicare. Helping with things like copays, deductibles and coinsurance.
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Plan G is currently the most popular option for new Medicare enrollees, as it covers nearly everything except the Part B deductible.
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Yes, but outside of your Initial Enrollment Period, you may face medical underwriting. That’s why enrolling during your guaranteed issue window is important.
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It depends. Medicare Supplement usually has higher premiums but gives you nationwide provider freedom and predictable costs. Medicare Advantage has lower premiums but may come with network restrictions and more out-of-pocket variability.
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Premiums vary by age, gender, state, and the standardized plan letter (A-N). Generally, the more comprehensive the coverage, the higher the premium.
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Yes. Medicare Supplement is widely accepted nationwide by any provider that takes Medicare.
Prescription Drug Plans (Part D)
Visit our Part D Page
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No, but if you don’t have creditable prescription coverage when you’re first eligible, you may face a late enrollment penalty that never goes away.
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Part D covers outpatient prescription drugs. Each plan publishes its own formulary. The list of drugs it covers are organized into cost tiers. Plans are offered by private insurers approved by Medicare, either as a standalone drug plan or bundled inside a Medicare Advantage plan. Because formularies differ, it's important to confirm your specific prescriptions are covered before enrolling.
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Yes. You can switch plans during the Annual Enrollment Period (Oct 15–Dec 7), or during certain Special Enrollment Periods triggered by life events.
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No. Each plan has its own formulary (drug list). It’s important to check whether your prescriptions are covered before enrolling.
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Once you hit the maximum out of pocket for that year (changes yearly), you are paid up for the remainder of the year.
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As of January 1, 2025, the donut hole is no longer applicable to all Medicare beneficiaries.
Additional Medicare Coverage (Dental, Vision, Hearing, etc.)
Compare your options on our Additional Coverage page
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No. Routine dental (cleanings, fillings, dentures) isn’t covered. You’ll need a separate dental plan.
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Not routine exams. Medicare only covers medically necessary eye care (like cataract surgery). Vision insurance fills the gap.
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No. Hearing aids and exams aren’t included, private coverage is needed.
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No. Medicare covers short term skilled nursing, but not custodial long term care.
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Yes. You can add dental, vision, hearing, and other plans to round out your coverage.
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We’ll help you compare standalone plans vs Advantage plans with add ons so you get complete protection.
Individual / Family Health Plans
Read more on ACA Health Plans on the Individual / Family Health Plans page.
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Yes, most households qualify based on income and family size. Even households making over $100K can still get reduced premiums in some cases.
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ACA plans cover essential benefits (preventive care, prescriptions, maternity, mental health) and always cover pre existing conditions. Short term plans usually do not and can deny coverage.
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The Open Enrollment Period runs from November 1 - January 15 in most states. You may also qualify for a Special Enrollment Period if you’ve had a life event like losing employer coverage, moving, or getting married.
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It depends on the plan’s network. We’ll help you find a plan that keeps your preferred doctors and hospitals in network whenever possible.
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Premiums vary by age, location, and plan tier, but subsidies significantly reduce costs for most people. We’ll run the numbers so you’ll know your true cost upfront.
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Yes. You can apply for individual or family coverage on a single application, each person can pick the plan that fits their needs.
Individual Dental Plans
See more on Dental Plans
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No. However, preventive care alone can save you thousands by catching problems early. Dental coverage also shields you from surprise bills when major procedures pop up.
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PPO offer more flexibility to choose your dentist and usually have larger networks. HMOs are lower cost but more limited.
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Some dental plans include orthodontic benefits, especially for children. Others may require add on coverage. We’ll help you compare.
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Often, yes (plan dependent). Many cover exams, cleanings, and X-rays with little to no out of pocket cost.
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Coverage varies. Some plans include implant allowances or partial coverage; others exclude them or have waiting periods. We’ll pinpoint plans that help with implants if that’s a priority.
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Most plans set an annual maximum between $750 - $10,000 per person. After that, you pay out of pocket.
Vision Plans
More on Vision Plans
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No. However, even with perfect eyesight, annual exams can detect early signs of health problems and keep your eyes healthy long term.
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Most plans let you choose one benefit per year, either glasses or contacts. Some plans offer an allowance that can be split.
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Yes. Plans typically include a frame allowance. You pay the difference if your chosen frames cost more.
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Not fully. Most plans offer discounts on LASIK and other corrective eye procedures.
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Premiums are ofter under $20/month, making vision one of the most affordable types of coverage.
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Yes. Many plans offer individual and family options so everyone can stay covered affordably.
Life Insurance
Details on Life Insurance
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The two main types are Term Life (coverage for a set number of years, usually lowest cost) and Permanent Life (Whole Life or Universal Life, which last a lifetime and can build cash value).
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It depends on income, debts, dependents, and future expenses like college. A common guideline is 10–12x your annual income, but we’ll help tailor coverage to your family’s needs.
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Not necessarily. Term life can be very affordable—sometimes less than $1/day for healthy applicants. Permanent coverage costs more but offers cash value and lifelong protection.
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Yes. Options like guaranteed issue or final expense insurance are available regardless of health, though premiums may be higher.
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Usually not. Employer policies are often limited (1–2x your salary) and end if you leave the job. An individual policy stays with you no matter where you work.
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Yes. Many carriers offer riders that provide smaller amounts of coverage for a spouse or child, or you can purchase separate policies for each family member.
Final Expense
Visit our Final Expense page.
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Final expense insurance, also called burial or funeral insurance, is a small whole life policy designed to cover end-of-life costs such as funerals, cremation, medical bills, or other final expenses.
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Policies are usually smaller than traditional life insurance, typically $2,500 to $50,000, making them affordable and easy to qualify for.
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It’s most common for people over 50, but some carriers offer it at younger ages too. Seniors like it because health exams are often not required.
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Yes. Many policies are guaranteed issue (no medical questions or exams). Others ask a few basic health questions but still accept most applicants.
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Premiums depend on your age, gender, health, and coverage amount, but plans are generally designed to be affordable on a fixed income.
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Yes. Most final expense policies pay benefits directly to your beneficiary or funeral home, often within a few days of claim approval, so loved ones aren’t left with financial stress.
Group Benefits
Group Health Plans (Medical, Dental, Vision)
For more, click Group Health Plans.
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Group benefits are employer sponsored insurance programs that can include health, dental, vision, life, and disability coverage. They provide employees with valuable protection while helping employers attract and retain talent.
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Costs vary by company size, industry, and coverage type, but employers often share costs with employees, making coverage more affordable for both.
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Offering benefits helps recruit and retain top employees, boosts morale, and may provide tax advantages for the business.
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No. Employees typically choose from available options during open enrollment and can opt into only the coverages they need.
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Yes. Employers can tailor benefits packages (medical, dental, vision, life, disability) to fit their workforce and budget.
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Employees have options like COBRA coverage or converting certain policies to individual plans to maintain protection after leaving.
Group Life Insurance
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Most plans cover either a flat amount (e.g., $25,000 or $50,000) or a multiple of the employee’s annual salary (commonly 1–2x).
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Yes. Many plans allow employees to buy supplemental coverage for themselves, their spouses, or dependents.
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Not for the base coverage. Supplemental coverage may require basic health questions or limits.
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Most plans offer portability (take the coverage with you) or conversion (switch to an individual policy).
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It’s one of the most affordable group benefits typically a few dollars per month per employee.
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No. Employers can cover the cost, share it with employees, or offer voluntary life as a 100% employee paid option.
Group Disability Insurance
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Short-term covers temporary conditions (weeks to months), while long-term protects against serious, lasting disabilities (years or more).
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Most plans cover 50–70% of base salary, though exact percentages depend on the policy.
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It depends. If the employer pays premiums, benefits are usually taxable. If employees pay with after-tax dollars, benefits are generally tax-free.
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If the disability is work-related, workers’ comp may apply first. Disability insurance often coordinates benefits to avoid overpayment.
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Yes. Many employers offer a base plan with the option to “buy up” additional coverage.
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It protects employees, strengthens retention, reduces absenteeism stress, and enhances your benefits package all while being cost effective.
Key Person Insurance
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Typically, anyone whose loss would seriously disrupt the business owners, executives, top sales producers, or specialists with unique skills.
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It depends on the value of the key person’s contributions. Common methods include multiplying salary, estimating lost revenue, or factoring in replacement costs.
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Yes. The company owns the policy, pays the premiums, and receives the death benefit.
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Personal life insurance protects an individual’s family. Key person insurance protects the business.
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Yes, in some cases. The company can transfer ownership to the individual or a new employer.
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It gives them confidence that if something happens to a critical person, the business will have funds to stabilize operations and repay obligations.
Buy-Sell Agreement Insurance
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A legal contract that outlines how ownership shares will transfer if an owner dies, becomes disabled, or leaves the business.
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Because insurance provides immediate liquidity. Without it, surviving partners may struggle to raise enough money quickly.
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In cross purchase, partners own policies on each other. In entity owned, the business owns the policies and handles the buyout directly.
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Typically through a pre agreed valuation method like book value, a multiple of earnings, or a professional appraisal.
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No, premiums are not deductible. But the insurance proceeds are usually received tax-free.
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Every few years or anytime the business value, ownership structure, or number of owners change.