Here’s a closer look at some often-overlooked expenses and how AME can support you: 

Facility Fees Beyond the ER Visit 

Hospitals may charge extra facility fees for using the emergency room, staying for observation, or being admitted as an inpatient. These fees often range from $1,000 to $2,000 for each visit.1 With AME coverage, eligible facility fees are paid in full up to your plan’s benefit limit. This means you can get the care you need without being left with large out-of-pocket costs after treatment. 

High‑Cost Diagnostic Services

Imaging exams like X‑rays, CT scans, MRIs and related lab work can run $500–$3,000 depending on complexity.2 AME reimburses eligible diagnostic expenses, allowing you to cover co‑pays and other out of pocket amounts on imaging up to your plan’s per‑accident limit. 

Urgent Care and Specialist Co-Pays 

If you need follow-up care at an urgent care center or with a specialist, you might face co-pays of $100 to $200 for each appointment, plus any deductible.3 You can use your AME benefits to helps cover these co-pays and deductible amounts for approved treatments, helping you manage costs, even if your recovery requires several visits. 

Emergency Transportation Charges 

 A ride in a ground ambulance typically costs between $400 and $1,000, while air ambulance transport can be more than $10,000.4 AME includes a special transportation benefit that reimburses you for ambulance and air ambulance services, up to your plan’s benefit amount. 

Medical Equipment and Supplies

Items like splints, braces, crutches, and casting materials can add unexpected costs. Basic supplies may start at $50, and specialty braces can cost up to $500.5 AME provides benefits for medical equipment prescribed after an accident, applied against your per-accident maximum, so you’re not left with the bill. 

Without the right coverage, out-of-pocket expenses for accidents can add up faster than you might expect. Having AME protection can make all the difference.  

For NCD members, NCDAccidentPrime delivers up to $15,000 per accident with zero deductible, plus enhanced transportation and treatment benefits. This coverage is underwritten by Zurich American Insurance Company. Prepare today and let your coverage handle the surprises tomorrow.   

1. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. “Costs for Hospital Emergency Room Visits.” (https://www.hcup-us.ahrq.gov/reports/statbriefs/sb268-ER-Costs-2017.jsp) 
2. GoodRx Health. “How Much Do X-Rays, CT Scans, and MRIs Cost?” (https://www.goodrx.com/healthcare-access/patient-experience/how-much-do-x-rays-ct-scans-mris-cost) 
3. Debt.org. “How Much Does Urgent Care Cost?” (https://www.debt.org/medical/urgent-care-cost/) 
4. [Health Affairs. “Ambulance Use and Costs Vary by State and Insurer.” (https://www.healthaffairs.org/content/forefront/ambulance-use-and-costs-vary-state-and-insurer)] & National Association of Insurance Commissioners (NAIC). “Air Ambulance Costs.” (https://content.naic.org/sites/default/files/inline-files/Air%20Ambulance%20Costs.pdf) 
5. Verywell Health. “How Much Do Crutches, Braces, and Other DME Cost?” (https://www.verywellhealth.com/durable-medical-equipment-costs-5198607) 

How Agents and Members Find the Perfect Ancillary Fit

You already know the under-65 health insurance market is full of opportunity—but it’s not one-size-fits-all. Within this age group, you’ll be speaking to everyone from young professionals to growing families, from gig workers to folks who are looking at early retirement. Each of these micro-demographics has unique concerns, priorities, and the potential for unique coverage gaps.

That’s why ancillary products—like dental, vision, accident, and critical illness insurance—are such powerful tools. They let you customize your recommendations and provide targeted solutions that increase client satisfaction, boost customer retention, and build out your bottom line.

(You can watch more on this topic from Ben Harrison, NCD’s Chief Revenue Officer, at this year’s Medicarians here:)

At NCD, we’re here to help you grow by serving every segment of the under-65 market with thoughtful, affordable options.

Young Adults: Budget-Conscious, Preventive-Focused

Young adults (ages 18–30) are often healthy and price-sensitive. They may skip routine care simply to save money. That’s where low-cost ancillary products like dental and vision plans come in.

These clients are typically open to plans that cover cleanings, eye exams, and basic preventive care—especially if it means avoiding big bills later. NCD’s dental products offer simple, transparent coverage that appeals to their DIY, mobile-friendly lifestyle.

Pro tip: Bundle vision with dental—it’s a high-value combo young adults want and are more likely to keep long-term. We recommend pairing plan for maximum coverage.

Families: Managing Costs and Planning Ahead

Parents with kids juggle nonstop priorities—from coordinating sports practices and club activities to scheduling annual check-ups and preventive appointments. It can feel like an endless checklist, so families need insurance that not only protects their health and wallet but also simplifies their lives.

Your role: Be the trusted advisor who helps families stay proactive—not reactive—when it comes to protecting their health and their finances. We point our families towards NCD Elite by MetLife plans, with a variety of annual maximums to choose from, plus great day-one coverage in most states.

Gig Workers & Freelancers: No Employer, No Benefits

This fast-growing segment includes rideshare drivers, creatives, and self-employed professionals. Many rely on ACA plans but lack access to traditional employer-sponsored benefits.

These clients are often underinsured and financially exposed. Ancillary products help fill critical gaps and give them the benefits they’d otherwise go without. Dental and vision plans are popular, but so are hospital indemnity and accident plans, which provide a safety net if they’re unable to work due to injury or illness.

Tip: Position separate ancillary products as part of a custom-fit solution that works together to meet the unique needs of freelancers, similar to employer coverage but tailored to fit. With so many options to choose from, explore all NCD plans available on the Agent Resource Hub.

Early Retirees: Bridge to Medicare

Adults in their 50s and early 60s may have left the workforce but aren’t yet eligible for Medicare. They’re looking for peace of mind and value-driven coverage.

This group often appreciates strong dental plans (including restorative services), and supplemental coverage that helps manage out-of-pocket costs until Medicare kicks in. Vision plans and critical illness coverage are especially attractive here.

Your opportunity: Help them feel confident and covered during this transition phase. We recommend NCD Complete by MetLife due to the coverage for major services like implants. It’s a great plan choice to both support this demographic’s needs now and get them engaged in higher co-insurance rates when they’re more likely to need it down the road.

Final Thought: Customize for Connection

You already have access to the under-65 market. Now it’s about meeting people where they are, understanding what matters most to them, and offering the right mix of solutions.

With NCD’s agent-friendly plans, you can customize your offerings, boost retention, and serve every demographic with confidence. To learn more about finding your perfect fit, grab some time with an NCD Account Executive today!

For many insurance agents, especially those seasoned in the Medicare space, the over-65 market is familiar territory. But there’s a growing opportunity many agents overlook: ancillary products for the under-65 market. Expanding your sales offerings to include essential ancillary products like dental, vision, accident, critical illness, and hospital indemnity insurance can help unlock significant benefits to a younger demographic.

At NCD, we believe in supporting all of our agents with products that meet real needs and help grow your business– and that means offering diverse coverage. Here’s why making this jump to include ancillary products for the under-65 market can be a powerful win for you and for your clients:

Diversify Your Revenue Stream and Differentiate Yourself

At NCD, we hear from agents every day who are looking for ways to deepen their value to clients. When you provide solutions that go beyond the standard health plan—like dental and vision coverage—you become more than just a sales contact. You become a trusted advisor.

On top of that, relying solely on Medicare can make your income vulnerable to seasonal limitations as well as policy changes. But ancillary products, especially in the under 65-market, are in-demand year-round. By branching out, you can create a more consistent, diversified income stream that isn’t confined to AEP or SEP.

Build Long-Term Client Relationships and Future-Proof Your Business

Broadening your offerings and your audience is a smart move because it allows you to build customer relationships and loyalty before your clients reach Medicare age. Agents who adapt and offer a more comprehensive portfolio remain competitive and responsive to market demands. In working with a younger demographic, you can increase your earning potential and truly stand out from the crowd.

When you offer multiple products that address real-life needs, you’re building long-term relationships—not just making one-time sales. Clients who feel supported and well-covered are more likely to stay loyal, refer friends, and look to you for future needs.

Plus, with ancillary products in your portfolio, you have more natural reasons to check in throughout the year. It’s a great way to stay top of mind and continue providing value outside the open enrollment window.

Serve Today’s Diverse Workforce

With more people working independently or for small businesses, traditional benefits aren’t always available. Ancillary products like dental, vision, and accident plans offer affordable, flexible options that make a real difference.

At NCD, we’re proud to offer plans that are perfect for gig workers, freelancers, and anyone looking to customize their coverage. Our plans are simple to understand, easy to enroll in, and are also available year-round, giving your clients the freedom to choose what works best for them, whenever and however they need it.

At NCD, we make it easy for agents to stay connected with tools, training, and top-rated support. Whether you’re selling dental plans to individuals or offering vision coverage to small groups, we’re here to help you succeed.

Fill the Gaps Left by Major Medical

If you’re feeling comfortable with your current over-65 sales focus, we always want to keep a good thing going! Even if you’re still in the investigation phase of broadening your business to an under-65 market, we encourage you to add NCD by MetLife and VSP Vision products to your list of offerings for the over-65 market.

Take dental insurance, for example. A routine cleaning might be manageable, but what happens when a client needs a root canal or crowns? With limited or hard to use embedded dental benefits, those costs can be overwhelming. With NCD by MetLife dental plans, your clients get access to a broad network, fast claims processing, and real savings—protecting both their health and their wallet.

Final Thoughts

Whether your market is primarily over-65 or you’re looking to branch out, the truth is clear: Ancillary products aren’t just extras—they’re essential. By offering dental, vision, and other supplemental coverage options, you’re helping your clients stay protected while growing your business in smart, sustainable ways.

Tip: One simple way to start broadening your market? Ask for referrals! How many of your existing over-65 customers have adult children who don’t have the coverage they need?

Partner with NCD to bring more value to your clients and take your practice to the next level. Ready to learn more? Contact Agent Support today to get started.

Pay attention to ACA Enrollment Data 

ACA sales are way down this year compared to last, but the story doesn’t stop there.

Our recent state level ACA Enrollment Trends Analysis reveals powerful insights into the role of brokers, marketers, and enforcement in reshaping the ACA landscape. For data enthusiasts (Ok, nerds) like us at NCD, these trends highlight critical shifts that demand attention.

Here’s a snapshot of the data:

• Healthcare.gov totals down 27.75% year over year
• State based exchanges up 32.44%
• Healthcare.gov new consumers- down 47.12%
• State based exchange new consumers up 64.29%

What’s driving these trends? Let’s dig deeper.

Key Trends Shaping ACA Enrollment

1. Healthcare.gov Struggles with Fraud Enforcement
Healthcare.gov has faced tighter fraud prevention measures, including stricter enforcement of broker-switching rules and a crackdown on shady marketing tactics. While these steps address critical issues, they’ve also created hurdles for brokers and marketers in scaling their efforts.

2. State-Based Marketplaces Are Thriving
State-based exchanges have experienced fewer fraud-related disruptions, with enrollments up 32.44% overall and 64.29% among new consumers. Localized adaptability and fewer compliance hurdles have made these exchanges more accessible to consumers.

3. Georgia’s Enrollment Crisis
Georgia’s dramatic 79.75% enrollment drop stems from its shift from Healthcare.gov to a state-based exchange. Many large ACA distributors, focused on the scalability of FFM states, deprioritized Georgia. This highlights the critical role of brokers and scaled marketing efforts in driving ACA enrollments.

NCD’s Commitment to Empowering Brokers

At NCD, we’ve built a reputation as one of the best-rated insurance plans in the country, just take one look at our google reviews.  We’re committed to supporting brokers through the shifting trends in this industry.

Our Role in the ACA Market
As a trusted partner to brokers and agents, NCD provides innovative dental and vision plans that complement ACA coverage. These plans meet consumers’ evolving needs, offering affordable and essential benefits alongside health insurance.

Data-Driven Insights for Better Decisions
We believe data isn’t just about answers—it’s about asking the right questions. That’s why our team works tirelessly to analyze emerging trends and equip brokers with actionable insights. By understanding shifts like these, brokers can better navigate challenges and seize opportunities in the ACA market.

Why These Trends Matter to NCD

The decline in ACA enrollments across FFM states underscores the need for trusted, value-driven coverage options. At NCD, we’ve seen a rising demand for dental and vision plans, especially as consumers seek comprehensive healthcare solutions.

Complementary benefits like ours are increasingly essential for consumers managing their healthcare budgets. Whether through brokers or direct enrollments, our plans provide flexibility, affordability, and peace of mind.

Actionable Takeaways for Brokers

Here’s what brokers can do to adapt to these trends:

• Focus on State-Based Exchanges: These marketplaces present growth opportunities with rising enrollments and fewer compliance challenges.
• Promote Complementary Coverage: Dental and vision plans are invaluable to consumers who want holistic care without breaking the bank.
• Leverage Data: Use insights like those provided by NCD to stay ahead of market shifts and position yourself as a trusted advisor.

Want to Explore the Full Dataset?

The ACA enrollment data reveals shocking swings of 40% or more in various states. From the CMS dataset to state-by-state analyses, we’re happy to share the details.

📩 Email us at agentinfo@ncd.com for the full dataset and insights.

Or, connect directly with Sam Melamed on LinkedIn here, NCD’s Chief Insurance Nerd and CEO, for a walkthrough of the numbers.

NCD: Your Partner in Navigating Healthcare Trends

At NCD, we’re dedicated to empowering brokers with innovative solutions and actionable insights. From ACA trends to best-in-class customer service, we’re here to help you thrive in an ever-changing market.

Data is rarely about the answers and mostly about asking the right questions from it. One fun thing about having really smart and quick data analysts on the NCD team is their ability to enhance the data questions while still cranking out great analysis. This post was made possible by NCD Business Analyst, Cooper Tretter.