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Founders Life and Health Blog

The Biggest Problems with the ACA Marketplace (and How to Avoid Them)

4/30/2025

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Let’s be honest: navigating the ACA Marketplace can feel like trying to read a medical bill in Latin. Confusing, overwhelming, and often followed by the phrase, “Wait, I have to pay *what*?” I’m Jo Hutchison, a health insurance broker with Founders Life and Health, and today we’re diving into the most common complaints I hear about ACA (aka Marketplace aka Obamacare) plans—and what you can do to dodge the biggest headaches.

1. “My plan doesn’t cover anything!”
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Yep, I hear this one all. the. time.

Here’s the likely issue: You probably enrolled in a plan that doesn’t offer any benefits until you hit a high deductible. That plan might’ve looked tempting—low monthly premium, right? But when you see things like “$20 copay *after deductible*” or “50% coinsurance *after deductible*”... that’s your red flag.

👉 Pro tip: Look for plans that list copays up front—*before* the deductible kicks in. Paying an extra $20 or so per month can save you hundreds down the line when you actually need to use the plan.

2. “My doctors aren’t covered!”
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The struggle is real. Network limitations are a legit downside of many ACA Marketplace plans.
If your favorite doctors are non-negotiable, make sure they’re in-network before you enroll. Use the Marketplace tools (or better yet, work with a broker—hi, that's me!) to check. And if there’s a doc you only see once a year, it might be worth paying out-of-pocket just to keep that relationship going.

And remember: Open Enrollment is your chance each year to shift plans and fix network issues. Mark your calendar!

3. “This isn’t affordable!”
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It’s literally called the Affordable Care Act, right? So why is your monthly premium more than your car payment?

A few things to double-check:
- Are you including your *entire* household size when applying, even if only you need coverage?
- Are you using your adjusted gross income (line 11 on your 1040), not your total income?
- Has your income changed (job loss, retirement, etc.)? You might be eligible for more help than you think.
And if your income is too low or too high for Marketplace subsidies, don’t panic:
- **Too low?** You may qualify for Medicaid in your state.
- **Too high?** Private PPO plans designed for self-employed folks might be a better fit—often with lower premiums and deductibles.

4. “My prescriptions cost a fortune!”
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This one’s a beast, especially if you’re taking specialty meds. Tier 4 and 5 prescriptions aren’t always well-covered on Marketplace plans.
If you’re stuck:
- Check with the drug manufacturer for copay assistance programs.
- Talk to your pharmacist—especially if it’s a specialty pharmacy. They know their stuff.
- Consider switching to generic versions (with your doctor’s blessing) when possible. Marketplace plans are usually more generous with generics.

Personal note: My son takes Humira for Crohn’s. I get it—these meds can be crazy expensive. But there *are* ways to make them more manageable.

Final Thoughts: Don’t Settle, Get Help
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The ACA Marketplace has its flaws, sure—but many of the biggest issues come from people not knowing how to work the system. That’s where a good broker can make all the difference. (Psst: our services are free!)
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Have a complaint I didn’t cover? Want help picking the right plan? Hit me up! I’m here to make health insurance suck less.
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Jo Hutchison | Founders Life and Health 
[email protected] | 314-899-7066 
www.founderslifeandhealth.com
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Medicare Open Enrollment

10/4/2023

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Welcome to Medicare Open Enrollment season!

 My name is Jo Hutchison. I am an independent health and Medicare advisor with Founders Life and Health here in beautiful St. Louis, Missouri.  Today, we are going to be doing a quick summary of Medicare open enrollment, what is it, how to use it. Everything you need to know to make sure that you have the best possible plan in place for next year.

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Losing Medicaid Coverage

3/16/2023

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If you are losing Medicaid coverage, you probably have a lot of concerns and questions about how you are going to get health insurance. My name is Jo Hutchison. I'm an independent health and Medicare advisor with Founders Life & Health, and today we are going to be talking about  losing Medicaid coverage, how to navigate that system and what your next steps are.

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Medicare Vs Medicaid

11/15/2022

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Medicare vs Medicaid, what to know in under 5 minutes!


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Obamacare Enrollment 2023

11/10/2022

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​Obamacare Enrollment 2023, What's new this year?

Obamacare enrollment period for 2023 is officially upon us, and you might be wondering if Obamacare is something that will work for you. HOW to get enrolled, WHEN to get enrolled, WHY it's important. That is exactly what we are going to be talking about today.

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Medigap Plan N Vs Plan G

10/1/2022

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Medigap Plan N vs Plan G

Are you looking at a Medicare supplement plan and trying to figure out what letter plan is best for you? Today, we are going to be looking at plans N and G, and comparing them in a very short, quick little summary on the differences between the two. So hopefully you can make the choice that's best for you.

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When Should I Enroll in Medicare?

9/28/2022

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Deciding when to enroll in Medicare

Are you almost 65?
If you are getting ready to turn 65 this year, you are not only probably getting bombarded with mail and calls about getting enrolled in Medicare, but you may be wondering, when am I supposed to enroll in Medicare? That is exactly what we're going to be talking about today
Hi, there. My name is Jo Hutchison and I am an independent health and Medicare advisor with Founders Life & Health here in beautiful St. Louis. And today, we are going to be talking about when exactly you can enroll in Medicare.

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How to Pick a Medigap Plan

9/26/2022

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How to Pick a Medigap Plan (Look for these 3 things!)

If you are just getting started looking at Medicare and what's available to you in Medicare, you may or may not have seen this chart here, which outlines all of the Medicare supplement letter plans. There is a lot going on in this chart. I know. This generally outlines all 10 of the Medicare letter plans that are available and all of the varying benefits. Decoding this bad boy can seem a little bit overwhelming, but that is exactly what we're going to be talking about today.

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Affordable Care Act Pros and Cons

9/20/2022

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Pros and Cons of the Affordable Care Act

​What are the pros and cons of the Affordable Care Act?
​If you are looking at health insurance and you've thought about looking at a policy on the Marketplace through the Affordable Care Act, but you don't really know what it is or how it all works, let's talk about it. That's exactly what we're going to be talking about today. Side note, if you are doing some kind of term paper on the Affordable Care Act and health policy, this is not the blog post for you. So you may want to check out some other blogs or videos on the side and try to get more information for your term paper that way. This is going to apply to people that are actually looking for health coverage.

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Finding Affordable Health Insurance

9/15/2022

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FINDING AFFORDABLE HEALTH INSURANCE

​Finding Affordable Insurance can be a little bit like trying to find a unicorn or a needle in a haystack, but it is not impossible.

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Is Medicare Free?

4/6/2022

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Is Medicare free? The answer is, as you would expect, it’s not so cut and dry. For some parts, yes, but for some parts, no. First thing’s first though, you will never hear the word free used all by itself from any legitimate Medicare representative. Medicare does not like the word free when it stands all by itself. You will, however, hear the words no charge, or zero premium. You might hear premium free, with the word premium in front of it, but never just the word free. Medicare does not like the word free all by itself.

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What is Medigap?

1/6/2022

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What is Medigap, also known as a Medicare Supplement?

Today we are going to be diving deep into Medigap and Medicare supplements, which are at the same thing.

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What is Medicare Advantage?

1/4/2022

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You have probably seen a ton of commercials, especially if it’s the fall, about Medicare Advantage Plans and all of the extra benefits that you receive. I personally think a lot of those commercials can be a little bit misleading, which I wanted to do a little bit more of a deep dive as far as how Medicare Advantage works and talk a little bit about what those commercials are really saying.

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The Basics of Medicare

12/17/2021

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​Turning 65?

If you’re getting ready to turn 65 you’re probably starting to think about Medicare. You’re also probably getting bombarded with calls and mail about Medicare. Today I am just covering the basics of Medicare, so stick around. Hi, my name is Jo Hutchison. I’m an independent Medicare advisor with Founders Life and Health and today we are talking about the basics of Medicare.

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Turning 65? How to Enroll in Medicare

10/7/2021

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If you are getting ready to turn 65, you’re probably being absolutely flooded with junk mail about Medicare. In addition to that, you are hopefully gathering your information and learning more about how to get enrolled in Medicare. What are all of your options? Let’s discuss further and get into the details.

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Medicare Explained: The 4 Parts of Medicare You Need to Know

9/29/2021

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Many of you who are approaching 65 will no doubt be bombarded with literature from Medicare in your mailbox. But what exactly is Medicare? What are your options? What are the four important parts?

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September 25th, 2021

9/25/2021

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Along with your bucket list trip to the Bahamas and swimming with dolphins, is there anything else you should do before your 65th birthday?

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Is Medicare Mandatory?

9/21/2021

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​As an expert Independent broker based in Missouri, I’m at my happiest when sharing my knowledge and helping you make the most informed decisions on Medicare-related issues, including which plans are best for you.

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4 Medicare Mistakes to Avoid, Read This Before Signing Up!

9/17/2021

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As everyone knows, the best way to avoid making mistakes is by asking questions! The best source to answer these questions is through experts, and the same goes for Medicare.

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How Does Medicare Work if I’m 65 and Still Working?

9/7/2021

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Many of my clients are turning 65 and still working. So it’s hardly surprising I get asked frequently about how Medicare works for those 65 and over who still have a job.

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