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Understand deductibles, find a doctor, and access preventive health services


published to May 4, 2017

Now that you have Marketplace health insurance, here are three tips for getting the most out of your health insurance.

Understanding your deductible

  • A deductible is the amount you must spend on covered medical services before your insurance company can start paying you. So, if the deductible is $1,000 for him, the plan will not pay for most services until he co-pays $1,000 for covered medical services that apply to the deductible.
  • It’s important to know which services in your plan don’t count toward your deductible. Some plans cover primary care visits before the deductible is reached. Other plans offer discounts on medicines, including generics.
  • Read your plan documentation carefully to find out what is covered before you reach your deductible.

Find a trusted “in-network” doctor

  • Even if you don’t need treatment right now, it’s important to find a trusted doctor who has an insurance plan. Contact your insurance company to see which providers are “in network”.
  • If the provider is “out of network” it will usually cost more.
  • Networks are subject to change, so check with your provider each time you book.

Get free preventive health services

  • All Marketplace plans provide free coverage for recommended preventive care when offered by a provider in our network. This includes vaccinations for children and adults, annual checkups for women, obesity screening, and counseling for people of all ages.
  • Please refer to A complete list of eligible services.



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