Here are three recommendations for getting the most out of your health insurance if you have Marketplace coverage:


Know what your deductible is

  • A deductible is a sum of the amount that you must pay for approved medical care in order to avoid paying taxes before your insurance company will begin to repay you. If the amount for your deductible is $1,000, your plan won’t cover most services until you’ve spent $1,000 on covered healthcare services that count toward your deductible.
  • It’s important to understand which services in your plan are exempt from your deductible. Some plans cover primary care visits before your deductible is met, and you only have to pay a copayment. Other programs provide discounts on prescription medicines, including generics.
  • Before you hit your deductible, read your plan paperwork carefully to discover what’s covered.


Find a doctor who is “in-network” and who you can trust

  • Even if you don’t need medical attention right now, it’s important to find a doctor you can trust who is part of your insurance plan’s network. Find out which providers are “in-network” with your insurance plan.
  • Using an “out-of-network” service will almost always cost you more.
  • Because networks fluctuate, it’s a good idea to double-check with your provider each time you schedule an appointment.


Take advantage of free health prevention services

  • When given by an in-network provider, all Marketplace plans cover recommended preventive health care at no cost. Immunizations for children and adults, yearly well-“woman visits” for women, obesity screening, and counseling for persons of all ages are all part of this program.
  • View the complete list of services that are covered.