Life changes. Your coverage should keep up.

• Plans that meet Affordable Care Act standards cover a set of essential health benefits and cannot deny coverage or charge more because of pre-existing conditions.
• Marketplace plans are grouped into metal tiers — Bronze, Silver, Gold, and Platinum — based on how costs are split between you and the plan, not on the quality of care.
• Depending on household income and other factors, you may qualify for premium tax credits that lower monthly costs on Marketplace plans.
• Enrollment is generally limited to the annual Open Enrollment Period or a Special Enrollment Period after a qualifying life event.

Worth askingAre my doctors and prescriptions covered, and what would a typical year cost — not just the monthly premium?

• Premium: what you pay each month to keep coverage active, whether or not you use it.
• Deductible: what you pay for covered services before the plan begins to share costs. Many plans cover certain preventive care before the deductible.
• Copay and coinsurance: a copay is a fixed amount for a service; coinsurance is a percentage of the cost you pay after meeting the deductible.
• Out-of-pocket maximum: the most you pay for covered, in-network services in a plan year. Premiums don’t count toward it.

Worth askingHow would my costs compare between a lower-premium and a lower-deductible plan if I needed care this year?

• Term life generally pays a death benefit to your beneficiaries if you pass away during the policy term.
• For the same coverage amount, term life typically has a lower initial premium than permanent life insurance.
• Some policies can be renewed or converted to permanent coverage, depending on the policy’s terms.
• Approval and pricing depend on the carrier’s underwriting, including age and health.

Worth askingHow long do the people who depend on me need protection, and how much coverage would they need?

• Permanent policies are designed to stay in force for life as long as required premiums are paid.
• Many permanent policies build cash value over time, which grows according to the policy’s terms.
• Premiums are generally higher than term life for the same initial death benefit.
• Loans or withdrawals against cash value can reduce the death benefit and may have tax implications.

Worth askingWhat is guaranteed in this policy, and what depends on future performance or assumptions?

• Dental plans often cover preventive care at a higher level than basic or major services such as fillings or crowns.
• Waiting periods for some services and annual benefit maximums are common on individual dental plans.
• Vision plans typically help with routine eye exams and provide allowances toward glasses or contact lenses.
• Provider networks matter — check whether your current dentist or eye doctor participates.

Worth askingAre there waiting periods for the care I expect to need, and what is the annual maximum?

• Accident plans pay benefits for covered injuries; critical illness plans pay after a covered diagnosis; hospital indemnity plans pay a set amount for covered hospital stays.
• Benefits are typically paid directly to you, and you decide how to use them — from deductibles to everyday bills.
• Benefit amounts are fixed by the policy, regardless of what your actual expenses are.
• These plans are not a replacement for comprehensive health insurance. Exclusions and pre-existing condition limitations may apply.

Worth askingWhich events or conditions are covered, and how would this fit with my current health plan’s deductible?