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Simply Coverage Under 65

Buying your own health coverage

If you are under 65 and buying for yourself, this is the page. Check your doctors and your prescriptions first, then enroll — on your own or with an agent.

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  • 25 yearsof experience as a licensed agent
  • License #988455a licensed Texas agent, not a call center

Three questions

How can we help you?

Step 1: which coverage do you need?

Nothing here signs you up for anything. You choose what happens next.

Simply Coverage

What to check before you pick a plan

Start with your doctors. A plan is only cheap if the people you already see are in its network. The enrollment tool lets you type them in and shows you which plans they belong to.

Then your prescriptions. Enter each medication and your pharmacy. Two plans with the same premium can be hundreds of dollars apart once your actual prescriptions are priced.

Then the bill that lands after a hospital stay. That is the one people forget about — what you pay before the plan takes over, and what you pay after.

Simply Explained

What you pay, and when, across a plan year

What you pay, and when, across a plan year An axis of annual covered spending crossed by two markers. Before the deductible is met you pay every covered bill at the negotiated rate and the plan pays only preventive care, at no cost to you. Between the deductible and the out-of-pocket maximum you pay a copay or coinsurance share on each bill and the plan pays the rest. Once the out-of-pocket maximum is met the plan pays 100 percent of covered care through year end and you pay nothing more for in-network care. The premium runs unbroken underneath all three regions: it is due every month whether or not you use care, and none of it counts toward either marker. The premium tax credit lowers the premium line only. Cost-sharing reductions move both markers left and attach to Silver plans only. What you pay, and when, across a plan year Structure: healthcare.gov (CMS) · not to scale — every plan sets its own amounts Annual covered spending Deductible met Out-of-pocket maximum met Cost-sharing reductions move both markers left · Silver plans only Before the deductible Between the markers After the maximum You pay Every covered bill, at the negotiated rate Your coinsurance or copay on each bill Nothing more this plan year, in network Plan pays Preventive care — at no cost to you The rest of each bill, after your share 100% of covered care, through year end Premium Due every month, used or not — and none of it counts toward either marker. The premium tax credit lowers this line, and only this line. Both markers reset at the start of each plan year. Out-of-network care may not count toward either. Some plans charge a set copay for certain visits or drugs before the deductible. Check the plan summary. What you pay, and when, across a plan year A vertical axis of annual covered spending, running down the page and marked at two thresholds in order. Before the deductible is met you pay every covered bill at the negotiated rate and the plan pays only preventive care, at no cost to you. Between the deductible and the out-of-pocket maximum you pay a copay or coinsurance share on each bill and the plan pays the rest. Once the out-of-pocket maximum is met the plan pays 100 percent of covered care through year end and you pay nothing more for in-network care. The premium runs unbroken alongside all three regions, as a rail down the right-hand side: it is due every month whether or not you use care, and none of it counts toward either marker. The premium tax credit lowers the premium line only. Cost-sharing reductions move both markers up the axis and attach to Silver plans only. What you pay, and when, across a plan year Structure: healthcare.gov (CMS) · not to scale — every plan sets its own amounts Annual covered spending Before the deductible You pay Every covered bill, at the negotiated rate Plan pays Preventive care — at no cost to you Between the markers You pay Your coinsurance or copay on each bill Plan pays The rest of each bill, after your share After the maximum You pay Nothing more this plan year, in network Plan pays 100% of covered care, through year end Cost-sharing reductions move both markers up the axis · Silver plans only Deductible met Out-of-pocket maximum met Premium Due every month, used or not — and none of it counts toward either marker. The premium tax credit lowers this line, and only this line. Both markers reset at the start of each plan year. Out-of-network care may not count toward either. Some plans charge a set copay for certain visits or drugs before the deductible. Check the plan summary.
Structure: healthcare.gov (CMS). Not to scale — every plan sets its own amounts.

Everything we place

Health under 65MedicareTurning 65Medicare AdvantagePart DSupplementalDental & VisionLife insuranceTravel abroadMedicare guides

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Simply Answered

Questions people ask us

Yes. The apply-on-your-own path takes you straight to the marketplace enrollment tool with our agency attached, so you can finish it in one sitting.

You answer a short set of questions first — who needs coverage, your doctors, your prescriptions and your consent — and then a licensed agent calls you already holding all of it.

No. It is blocked outside the US. If you are traveling when you need to enroll, wait until you are back or call us.

Simply Committed

Ready when you are

Pick your path above, or let a licensed agent do it with you.

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Simply Health Insurance Agency — we’ve got you covered

Licensed Insurance Agency. Simply Health Insurance Agency is an independent insurance agency. We are not connected with or endorsed by the United States government or the federal Medicare program.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Medicare has neither reviewed nor endorsed this information.

Applying through a link on this page takes you to the carrier's or the marketplace's own website. Your application, your payment and your policy are handled there, under that company's terms and privacy policy.

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