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    18 Helpful Hints For Anyone Who's Ever Been Confused About Health Insurance

    TLDR; it's v. confusing but so important.

    If you feel totally lost when it comes to health insurance, you're not alone. Understanding what's covered and how much you'll actually end up paying isn't always super obvious.

    To help you out (and, honestly, to help myself), I chatted with an insurance analyst to get the lowdown.

    1. There are a few ways you can get health insurance. In the US, most people get theirs through Medicaid, through an employer, or from a plan they select on the health insurance marketplace (sometimes called the Affordable Care Act (ACA) plans or Obamacare).

    Screenshot of Medicaid levels for New York

    2. The good news is that if you don't qualify for Medicaid and don't have an employee-sponsored health plan, you could still qualify for financial assistance from the health insurance marketplace.

    Screenshot of the healthcare marketplace

    3. But keep in mind that you can usually only enroll for a plan through the health insurance marketplace during the open enrollment period — and once you pick a plan, you'll probably be stuck with it for the year.

    Screenshot of 2021 open enrollment dates

    4. Before you start shopping for health insurance on the marketplace, you need to understand the system and figure out how much you can afford to pay.

    Bronze, silver, gold, and platinum tier plans listed on California's healthcare exchange website

    5. If you're young and healthy, you might select a lower-tier plan with a lower premium (aka the plan's monthly cost).

    6. If you know you require regular healthcare, a higher-tiered plan with a higher premium might make more sense.

    Young woman talking to her doctor during an appointment

    7. Either way, if there's a doctor you like or any medications you take regularly, make sure it's covered under the plan you choose.

    Screenshot of the difference in coverage between in and out of network providers

    8. But know that even if your care or medications are covered, you might still have to pay a copay and/or coinsurance.

    9. Also, the copays you pay and your monthly premiums typically don't count toward your deductible.

    10. Which begs the question: What is a deductible, what is an out-of-pocket maximum, and how do they differ?

    Screenshot of difference between a deductible and an out-of-pocket maximum

    11. If there’s more than one person on the plan, there will be a separate family deductible and family out-of-pocket max.

    12. Anything not covered by your insurance (out-of-network care) will be noticeably more expensive.

    13. If you're traveling in another state and something happens, emergency and urgent care are usually covered. But international travel has its own set of rules.

    14. Even if you're in your home state, it might be worth it to come up with an emergency care plan in advance.

    15. Health insurance can be confusing and even intimidating, but once you have it, make sure you use it — especially any fully covered preventative care services.

    16. And keep in mind that most healthcare plans don’t include dental and eye care. You have to buy that insurance separately.

    Screenshot of dental and vision plans

    17. It's also important to note that other healthcare options exist.

    Screenshot of alternate health plans

    18. Technically it's required by law to have health insurance, but there's no federal penalty for those who choose not to buy it. (How's that for confusing?)

    Screenshot of the new policy for people who choose not to get insurance

    Phew, I think that's it. Do you have a health insurance tip that's helped you in the past? Share it in the comments below.

    And for money tips and tricks, check out the rest of our personal finance posts.