November 6, 2026 · 4 min read
Open Enrollment Is Here. The First Question Isn't Price, It's Which Market You Belong In
Every open enrollment season, the same thing happens. People open a browser, see a wall of plan names and monthly prices, and start comparing numbers that were never built for them. The price is the last thing to look at. The first thing is which market you belong in, because the two markets price you on completely different information.
Two markets, two different yardsticks
Public marketplace plans, the ones most people know as Obamacare, are based on your income. What you pay has nothing to do with your health. Those plans were designed first for people with major pre-existing conditions, and for households that qualify for substantial government assistance to bring the cost down.
Private plans work the other way. They are underwritten, which means they are based on your health. Your income does not set the price. Your health history does.
Why this order matters
If you qualify for real government assistance, a public plan can be the right call and it is not close. But if you do not qualify, the public sticker price is simply the price, and healthy people often end up paying for a structure that was never priced for them.
On the private side, being relatively healthy is an advantage instead of a footnote. Private plans also typically come with access to nationwide PPO networks, which means your doctors are far more likely to be covered wherever you are.
The questions that sort it out
An advisor can usually point you at the right market with four questions. Would you say you are relatively healthy? Any hospitalizations in the past five years? Any cancer, heart attack, diabetes, or stroke? And would you qualify for government assistance based on your income?
Your answers do not just pick a market. They decide which prices are even worth comparing. That is the whole point of asking them first.
Where to start
If you want to walk through those four questions for your own situation, start your application and we will go over both markets together, in real time, with your doctors and prescriptions in front of us.
Start your application