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Insurance Knowledge Hub

Clear answers about coverage, costs and the rules behind your options.

Educational guidance, not a policy quote or tax advice. Eligibility, costs and benefits depend on your plan, location and circumstances. Source references are listed with each topic.

Medicare & Supplemental Rules

Is Plan G better than Medicare Advantage for fixed incomes?

Medigap Plan G vs. Medicare Advantage Cost Structure
Rule or costOriginal Medicare + standard Plan GMedicare Advantage
Monthly premiumsPart B premium + Plan G premium; separate Part D premium if enrolledPart B premium + plan premium; $0 additional plan premiums exist in some areas
Part B deductibleYou pay 100% of the Part B deductible; standard Plan G does not cover itPlan-specific deductibles and cost sharing apply
Covered medical cost sharingStandard Plan G generally pays the 20% Part B coinsurance for Medicare-covered servicesCopays or coinsurance vary by service, up to the plan's Part A/B spending limit
Provider accessProviders who accept Medicare; not every provider accepts MedicareHMO/PPO network rules; out-of-network coverage depends on the plan
Prescription coverageNot included in Plan G; usually requires separate Part DOften included; verify the drug formulary and pharmacy network

Standard Plan G only; high-deductible Plan G has different costs. $0 premium does not mean $0 total cost. Actual premiums and spending limits vary by year, location and plan.

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ACA Marketplace Subsidies & Tax Calculations

Can I get a marketplace subsidy if I am self-employed?

Illustrative monthly premium calculation

$600 plan premium − $400 eligible tax credit = $200 monthly premium.

Example only, not a rate or eligibility estimate. Deductibles and copays are separate; actual assistance depends on current Marketplace rules and your application.

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Dental Insurance vs. Savings Plan Comparisons

How do dental savings plans differ from standard dental insurance?

Traditional Dental Insurance vs. Dental Savings Plan
Rule or costTraditional dental insuranceDental savings membership
Payment structurePremiums + applicable deductible and covered-service cost sharingMembership fee + discounted dentist charges; not insurance
Annual maximum / discountsIllustrative annual insurer benefit cap: $1,000–$2,000; some policies differ or have no capIllustrative advertised discount range: 10%–60%; depends on dentist and procedure
Major workCrowns may have waiting periods, exclusions and benefit limitsContracted discounts only; verify the actual fee for crowns or implants
Example treatment mathAt 50% covered-service benefits, a $1,000 eligible charge could leave $500 to you, before deductible and limitsA 20% discount on a $1,000 listed charge leaves $800 to pay, before membership fees
Provider rulesNetwork and out-of-network benefits vary by policyParticipating dentists and scheduled procedures only

All amounts and percentages are illustrative, not quotes or guaranteed benefits. An insurance benefit cap limits the insurer's payment, not your out-of-pocket spending. Compare the actual policy and membership fee schedule.

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Group Insurance & Employee Benefit Mechanics

What is an ICHRA and how does it benefit small business employees?

Group Health Insurance vs. Individual Coverage HRA (ICHRA)
Rule or costGroup health insuranceICHRA
Coverage choiceEmployer selects the group plan optionsEmployees select qualifying individual coverage or Medicare
Employer fundingEmployer shares premium costs; contribution and participation rules vary100% employer-funded allowance; no federal annual contribution cap
Illustrative contribution50% of a $600 monthly premium = $300 employer + $300 employee; not a universal minimum$300/month allowance = $3,600/year; unused amounts follow the arrangement's rules
Marketplace tax creditsAffordable, minimum-value employer coverage generally blocks employee premium tax creditsAccepting ICHRA blocks credits for the same months; an unaffordable offer may permit opt-out and credits
AdministrationGroup enrollment, renewals and applicable continuation dutiesCoverage and expense substantiation, employee notices and class rules

Examples are arithmetic only. ICHRA is a reimbursement arrangement, not insurance. Affordability tests, employee-class rules, employer-size obligations and state requirements need a case-specific review.

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