Expert Help Navigating Individual and Family Health Insurance Plans
Individual and family health insurance is coverage purchased directly by a person or household, usually through the ACA marketplace, rather than through an employer. Health & Benefits Partners helps individuals and families in Pennsylvania, New Jersey, and Delaware compare ACA-compliant health plans, apply for subsidies, and make confident enrollment choices. Whether you’re between jobs, self-employed, retiring early, turning 26, or need coverage for your family, we make the process easier.
What is Individual Health Insurance?
Individual health insurance is coverage you buy directly – not through an employer. All plans must meet Affordable Care Act (ACA) standards, meaning they:
No Denials for Pre-Existing Conditions
All ACA-compliant plans must accept everyone, regardless of medical history.
Essential Health Benefits Included
All plans must cover preventive care, maternity, prescriptions, and more.
Out-of-Pocket Cost Limits
Your plan must include annual caps to protect against high medical bills.
Plans can be:
- On the Marketplace (eligible for subsidies based on income)
- Off the Marketplace (direct from a carrier, sometimes with different networks)
All ACA-compliant plans cover:
- Preventative care and screenings
- Prescription medications
- Emergency services and hospitalization
Why People Choose Individual Plans
How We Help You Enroll
Our licensed advisors offer personalized support from start to finish – so you don’t have to navigate the individual health insurance process alone. We simplify enrollment by helping you:
We work with trusted carriers like Independence Blue Cross, Highmark, Jefferson Health, and Ambetter – plus other regional and national providers – to help you find the right fit.
When Can You Enroll?
Open Enrollment
November 1 to January 15 every year
Apply, renew, or switch coverage for the upcoming plan year.
Special Enrollment Period (SEP)
You may qualify if you’ve experienced a Qualifying Life Event (QLE) such as:
- Job loss or change in coverage
- Moving to a new state or ZIP code
- Marriage, divorce, or legal separation
- Birth, adoption, or change in household
- Turning 26 and aging off a parent’s plan
We’ll help confirm eligibility and keep you on track during enrollment.
Frequently Asked Questions (FAQs)
Yes. If your income is under 400% of the Federal Poverty Level, you may qualify for:
- Premium Tax Credits (monthly discount on your plan)
- Cost-sharing reductions (lower deductibles, copays on Silver plans)
We’ll calculate your eligibility and help with Marketplace enrollment.
- On-Marketplace plans qualify for subsidies.
- Off-Marketplace plans are bought directly from insurers and may offer different networks or pricing.
Yes. ACA-compliant plans must cover all pre-existing conditions – no exclusions or higher rates.
No. If you qualify for Medicaid based on income, we’ll point you to the correct state Medicaid agency. We do not provide Medicaid enrollment services. Our advisors specialize in ACA Marketplace plans for individuals who do not qualify for Medicaid or job-based coverage.
Work with a Local Advisor
We’re based in the Philadelphia metro area and serve clients across Pennsylvania, New Jersey, and Delaware. Our support is:
Free to You
We're compensated by the carriers, not by your choices.
Local and Licensed
We understand the regional plans, networks, and enrollment rules.
Personal and Pressure-Free
Our only goal is helping you choose what fits best.
Whether you’re enrolling for the first time or switching plans, we’ll help you every step of the way.
★★★★★“I can not say enough about Adam and his team at Health and Benefits Partners.”
They are literally the best company that I have worked with and I wish that they did other facets of business, so that I could use them for everything! Health and benefits can be tricky even in the best of times. But, in this difficult time, Adam has made this so smooth when it could have been rocky. Five stars all day long.
Ready to Explore Plans?
Let’s find a health plan that actually fits your needs.
No cost to you. No pressure. Just clear guidance.
Disclosures
We are compensated by the insurance carriers for policies you choose through us. There is no direct cost to you. Compensation may vary by carrier and product. Information on this page is for educational purposes and does not constitute legal, tax, or accounting advice. Please consult your professional advisors about your specific situation. Tax treatment of ICHRA reimbursements can vary by employer and employee. We are licensed to advise clients in Pennsylvania, New Jersey, and Delaware. Contact us to confirm availability in other states.
