Your result
How many did you get right out of 15?
12 to 15You know how plans work beneath the price tag. Use the checklist below to confirm the details for the coming year.
7 to 11You know the vocabulary. The questions you missed are the parts of a plan worth ten extra minutes before you enroll.
0 to 6Nobody is taught this, and several of these rules run against common sense. Start with the first two links below.
All fifteen answers in one place
| 1 | A lower premium can cost more over the year. Add twelve premiums to the care you expect. |
| 2 | At most large employers, the employer’s own money pays the claims. |
| 3 | Metal levels describe how costs are split. They are not a quality rating. |
| 4 | Tobacco use can raise an individual premium by up to 50 percent. Health history cannot. |
| 5 | Networks change each year. Check your doctors again under the exact plan name. |
| 6 | Doing nothing usually means automatic renewal, with a new price and possibly new terms. |
| 7 | HMO and EPO plans generally pay nothing for non-emergency care outside the network. |
| 8 | Emergency care is covered at in-network cost sharing anywhere in the country. |
| 9 | A covered drug still has a tier, and may need prior authorization or step therapy. |
| 10 | Adult dental care is not a required benefit. |
| 11 | HSA money carries over and stays yours. Unused FSA money is generally forfeited. |
| 12 | Marriage, a job or a separate address do not end coverage on a parent’s plan before 26. |
| 13 | Short-term plans can exclude pre-existing conditions and cap what they pay. |
| 14 | The Summary of Benefits and Coverage prices three real situations for every plan. |
| 15 | Fewer than 1 percent of denied claims are appealed. |
Before you enroll, check these five things
- Estimate next year’s care: regular visits, prescriptions, anything planned.
- For each plan, add twelve months of premiums to your expected costs, then look at the out-of-pocket maximum for a bad year.
- Search the coming year’s directory for every doctor and hospital you use.
- Look up each medication on the plan’s drug list and note the tier and any codes.
- Open the Summary of Benefits and Coverage and compare the three coverage examples.
Keep reading
- Open Enrollment Starts November 1. These 3 Dates Decide When Your 2027 Coverage Begins
- Before You Hit “Renew,” Look at These 6 Things
- 7 Health Insurance Terms That Can Cost You Money If You Misunderstand Them
- Take the next quiz: Can You Read a Medical Bill?
Sources: HealthCare.gov, guidance on plan categories, plan types, premiums, essential health benefits, automatic re-enrollment and young adult coverage; KFF, Employer Health Benefits Survey and analyses of claims denials and appeals in HealthCare.gov plans; Internal Revenue Service, Publication 969; Centers for Medicare & Medicaid Services, No Surprises Act and short-term insurance consumer information. This quiz is general information and is not financial or tax advice. Plan details vary by state and by insurer.