One of the most common—and misunderstood—questions I hear is:

“Can I get health insurance for free?”

You’ve probably heard this from a friend, seen it on social media, or maybe even assumed it yourself.

Let me be clear: Health insurance is not free for everyone. That’s a myth. And today, I’m going to break down exactly why that is—so you can make smart, informed decisions that won’t cost you later.

The Myth of “Free” Insurance

The U.S. health insurance system is made up of many private companies. Under Obamacare (also known as the Affordable Care Act), these companies are required to offer coverage—even to those with pre-existing conditions, like high blood sugar.

Obamacare also mandates that all plans cover ten essential health benefits. Sounds great, right?

But here’s the reality:

• Only a few companies like Blue Cross remain actively in the exchange.
• Others have pulled out because they couldn’t afford to continue covering high-risk patients.

By year-end, these companies review their costs and often determine it’s unsustainable to stay in the marketplace.

So where does the belief in free insurance come from?

The 15% That Shift the Balance

Statistics show that around 15% of enrollees need consistent, costly medical treatment. The other 85% are generally healthier—some may have manageable issues like high blood pressure, but nothing major.

That 15% creates a financial imbalance that has to be offset by higher premiums. That’s why people assume the system is broken or “free.”

The truth is, most people pay for insurance.

What About Tax Credits?

Now let’s talk about the premium tax credit—a key part of the ACA.

This credit is based on your projected income. If your income falls within a certain range, you can get a subsidy (tax credit) that helps cover your premium.

• If your income stays within the predicted range, you don’t have to repay anything.
• But if you end up earning more than expected—say, you get a new job or unexpected income—you may have to repay the subsidy at tax time.

And this can be a big number—thousands of dollars in one lump sum.

That’s why I always say: Be careful when estimating your income.

The Value of Working With a Broker

This is exactly where a broker can help. Brokers like myself don’t charge for our services, and we help you:

• Understand your eligibility
• Project your income accurately
• Choose the right plan for your situation

We all want to earn more year over year. But if your final income doesn’t match your initial estimate, it could cost you.

Obamacare vs Traditional Plans

What makes Obamacare plans different from traditional insurance?

• Obamacare covers chronic conditions and maternity care.
• Traditional plans typically do not cover chronic illness or childbirth.

Young, healthy women often assume they won’t need this coverage. But childbirth can come with complications—and insurers don’t want to take on that risk upfront.

Some traditional plans will only offer coverage after the baby is born and both mother and child pass medical evaluations.

Also worth noting: Traditional plans don’t factor in your income. So if you’re a high earner, they may be more cost-effective.

What About Provider Networks?

Let’s say you live in New Jersey and like a specific doctor. If that doctor isn’t in your plan’s network—especially under Obamacare—you may have to pay out of pocket.

But some traditional plans have broader networks or national PPO access.

Here’s a number to think about:

With a traditional plan, you could save $350/month per person.

If both you and your spouse work, that’s $700/month back in your pocket. That’s significant.

Alternative health insurance plans offer amazing value for healthy individuals. But remember:

Being informed is the most important part of buying insurance.

If you’re considering a plan, contact us at eHealth. We’ll help you choose an option that won’t break the bank—and that actually fits your life.