Question 1

What does it mean that DRMA is an independent brokerage?

Accepted Answer

DRMA Insurance Agency is an independent insurance brokerage — we are appointed with multiple carriers rather than working for any single one. That structure lets us line plans up side by side instead of steering you toward one carrier’s house brand. Compare that with a captive agent (works for one carrier and sells only that carrier’s products) or going direct to a carrier yourself, where you get one quote and no comparison.

Question 2

Does using a broker cost me anything?

Accepted Answer

No. Our consultations, plan comparisons, enrollment help, and ongoing support are free for individuals, families, and groups. The carrier that issues your policy pays us a commission — your premium, your coverage, and your out-of-pocket costs are exactly the same whether you use DRMA or go direct. If you want to verify, take the plan we recommend to the carrier yourself and price it that way.

Question 3

How does DRMA actually find the right plan?

Accepted Answer

The issuing carrier pays us a commission when you enroll — your premium and coverage don’t change. We start with three concrete inputs: your doctors (names and clinics), your prescriptions (drug + dose + frequency), and your realistic budget (what you can absorb monthly and in a sudden expense). From there we run an apples-to-apples comparison across the carriers we work with, ranking on total expected annual cost — premium plus realistic use — not on sticker price alone.

Question 4

What is the difference between HMO, PPO, and EPO plans?

Accepted Answer

HMO plans use a defined network of doctors and hospitals, generally require you to choose a primary care physician, and need a referral before seeing a specialist; out-of-network care is typically not covered except in emergencies. PPO plans also use a network but let you see out-of-network providers at a higher cost — no referrals required. EPO plans sit between them, with a defined network like an HMO but no referral requirement like a PPO; out-of-network care is usually not covered. We match the network style to your doctors and travel patterns rather than picking from a single carrier’s lineup.

Question 5

Can I be denied or charged more for a pre-existing condition?

Accepted Answer

Under the ACA Marketplace, carriers cannot deny you coverage or charge you more because of a pre-existing condition — that has been federal law since 2014 and applies to all Marketplace plans. The same protection applies to most employer group plans. Medicare works differently: Original Medicare does not underwrite based on health history, but Medigap (Medicare Supplement) plans in some states do medical underwriting outside your guaranteed-issue window. Because the Medicare rules vary, we recommend a short review of your specific situation before you sign up.

Question 6

Are family plans different from individual plans?

Accepted Answer

On the ACA Marketplace, a family can be covered on a single plan together — spouses and dependent children qualify, and household income across the family is what the subsidy calculation uses. Individual Marketplace plans are a good fit for adults without dependents, including single adults whose income qualifies them for tax credits. Pediatric dental and vision are typically separate add-ons even on family plans, and adult dental and vision is usually sold separately as well. We line up the right combination of medical and ancillary coverage for your household.

Question 7

When can I enroll in or change coverage?

Accepted Answer

For ACA Marketplace plans, Open Enrollment runs November 1 through January 15 in most states — that is the annual window when you can enroll, switch, or renew coverage for the coming year. Outside Open Enrollment you can still make changes if you qualify for a Special Enrollment Period triggered by a life event like losing other coverage, moving, marriage, birth of a child, or a household income change. Medicare has its own calendar: AEP runs October 15 through December 7, with a Medicare Advantage Open Enrollment Period January 1 through March 31. Tell us your situation and we will figure out the date math for you.

Question 8

Do I qualify for a subsidy?

Accepted Answer

Most Marketplace applicants qualify for an Advance Premium Tax Credit (subsidy) that lowers the monthly premium, based on estimated household income, household size, and the cost of the second-lowest-cost Silver plan in your ZIP code. The typical qualifying range runs from roughly 100% to 400% of the federal poverty level, and recent legislation has extended eligibility above that historical cap for many households. At lower incomes, Cost-Sharing Reductions lower deductibles and copays on Silver plans as well. Your actual income is reconciled at tax time, so if your income changes during the year, flag it to us and we can adjust.

Question 9

Do you help after I enroll, or only at sign-up?

Accepted Answer

DRMA stays your point of contact after enrollment, not just at sign-up. When something goes sideways — a denied claim, a billing surprise, a network question, a new prescription that needs a workaround — we pick up the phone. We also run an annual review before Medicare AEP each fall and re-check during ACA Open Enrollment, so if your doctors or prescriptions have changed we surface the better-fit plan before it lapses silently.

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Common health insurance questions, clearly answered