Frequently Asked Questions

Working With Legacy Health Advisors

Is there a cost to work with you?

There is no direct cost for our guidance. As an independent health insurance broker, we are compensated by insurance carriers — not by charging clients directly. Your premium remains the same whether you enroll on your own or with our assistance.

Why should I work with Legacy Health Advisors?

We take a thoughtful, side-by-side approach to reviewing your options. Our goal is to help you understand your coverage before you enroll — including provider networks, prescription coverage, deductibles, and long-term cost structure.

You’ll have a knowledgeable advisor in your corner throughout the year — not just at enrollment.

What does the process look like?

1.     Review your current situation, healthcare needs, and budget

2.     Compare ACA marketplace and alternative coverage options side-by-side

3.     Enroll confidently with ongoing support throughout the year

No pressure. Just clear guidance.

ACA & Enrollment Questions

Do I have to wait for Open Enrollment to get coverage?

Open Enrollment applies to ACA marketplace plans. However, you may qualify for a Special Enrollment Period due to life events such as:

  • Loss of employer coverage

  • Marriage or divorce

  • Birth or adoption

  • Moving to a new coverage area

We’ll review your eligibility and timelines together.

Can I compare my employer plan with ACA marketplace options?

Yes. Many Utah families assume their employer coverage is their only option — especially when adding a spouse or children becomes expensive.

We compare total household costs, provider access, and plan structure to determine what makes the most sense for your situation.

Is private health insurance available year-round?

Some medically underwritten private plans may be available outside of ACA enrollment periods. Eligibility depends on health qualification and other factors. We review all available options and explain the differences so you can make an informed decision.

Understanding Your Health Insurance Plan

What is a health insurance premium?

Your premium is the monthly amount you pay to maintain your coverage. In addition to your premium, you may also have deductibles, copays, or coinsurance depending on your plan.

What is a deductible?

Your deductible is the amount you pay out-of-pocket for covered services before your insurance begins sharing costs. Some plans include services that are covered before the deductible is met.

 What is a copay?

A copay is a fixed amount you pay for specific services, such as doctor visits or prescriptions. The amount varies depending on your plan and the service provided.

What is an out-of-pocket maximum?

Your out-of-pocket maximum is the most you will pay for covered services in a plan year. Once you reach that limit, your plan pays 100% of covered medical expenses for the remainder of the year.

 What types of provider networks are there?

Common network types include:

  • HMO (Health Maintenance Organization)
    Lower cost structure, requires in-network providers and referrals for specialists.

  • PPO (Preferred Provider Organization)
    Greater flexibility with nationwide acceptance and no referral requirement.

  • EPO (Exclusive Provider Organization)
    In-network only except for emergencies.

  • POS (Point of Service)
    Hybrid model that requires referrals for specialists but allows some out-of-network coverage.

We’ll explain how each network impacts your provider access and total cost before you enroll.