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Let's break down health insurance

We’re here to answer questions and help you explore your options!

Health insurance can be like a new cell phone: Challenging to figure out, but still worth carrying with you.

Health insurance is important, whether you have no health issues or are living with a long-term condition. Understanding the basics can make it less confusing and may help you take a more active role in your own care.

Gabby

You’ll see a lot of me throughout this site providing helpful tips and guiding your experience. Ready? Let’s get started!

There are a few different types of health insurance

Do you know which one you have? If not, no worries! Our experts below are lined up and ready to help navigate you through each one.

Max, the commercial expert
Commercial insurance

Also called “private insurance,” this is a health insurance plan provided by and administered by a private insurance company rather than the government. You may receive it through your employer.

Beth, the Medicaid expert
Medicaid

A government-run health insurance program for low-income families, pregnant women, the elderly, and people with disabilities.

Tom, the Medicare expert
Medicare

A federal health insurance program for people aged 65 or older and for younger people with certain types of disabilities.

Chris, here to help you find a plan
Are you uninsured?

If you don’t have health insurance, learn about things to consider when selecting a plan that’s right for you.

I’m Chris—and I’m here to help you find a plan
Are you uninsured?

If you don’t have health insurance, learn about things to consider when selecting a plan that’s right for you.

Common questions about health insurance

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What’s the difference between medical vs prescription insurance?

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Is my medicine covered by health insurance?

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How can I get health insurance if I don’t have it?

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How can I afford my medicine if I don’t have health insurance?

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What is “commercial” health insurance?

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Is Medicare the same as Medicare Part D?

What is the difference between medical vs prescription insurance?

Medical insurance generally covers expenses like doctor visits, lab work, and hospital stays.

Prescription insurance generally covers prescription drugs.

Your health insurer may cover both types of insurance in one plan, or separate them into two parts. If your prescriptions are covered separately, you may have a  pharmacy benefits manager (PBM). To find out how your prescriptions are  covered, go to your health insurer’s website or call its customer service number, which you may find on your health insurance card.

Is my medicine covered by health insurance?

The answer to this can be confusing: It varies by insurance company and plan. Generally, insurance companies set up a formulary–a list of drugs that the plan covers. To find out whether your medicine is covered, check your formulary or call your health insurance company.

Time to choose a plan

Some people don’t really have a selection of health plans. They might need to take Medicaid or a single plan offered at work. Others must make a choice: They’re looking at many different plans offered at work, or on the Health Insurance Marketplace, or by private insurance companies. Maybe Medicare is another option. The bottom line: If you’re choosing between health plans, certain tips and strategies can help you pinpoint the best option for you.

How can I get health insurance if I don’t have it?

If you don’t have health insurance, we have information on the types of things you should consider when finding a plan that’s right for you.

How can I afford my medicine if I don’t have health insurance?

You may benefit from:

  • {link-resourses}
  • The Medicine Assistance Tool, a search engine for resources that can help you pay for prescriptions
  • A prescription discount card such as GoodRx

Ask your doctor for other resources that may help.

What is “commercial” health insurance?

Also called “private insurance,” this is a health insurance plan provided by and administered by a private insurance company rather than the government . You may receive it through your employer.

Max icon

Hi! Max here. Need more info on commercial? I can help with that.

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Did you know?

There are prescription savings offers for patients with commercial health insurance.


Is Medicare the same as Medicare Part D?

Not exactly. Medicare covers many types of services, and it’s divided into four parts. Part D helps patients pay for outpatient prescription drugs.

Tom icon

Hi! Tom here. Need more info on Part D and the other benefits that Medicare covers? I can help with that!

Test your knowledge

Test your knowledge

Gabby, ready to test your knowledge

How much have you learned about health insurance so far?

Take this quiz to find out!

How much have you learned about health insurance so far?

Take this quiz to find out!

Commercial health insurance is
provided and administered by:

Correct!

Want to know more about commercial insurance? {link-quiz-commercial}

Commercial health insurance is a private plan. You might buy it yourself or get it through your employer. It is provided and administered by someone other than the government.

Medicaid is for:

Correct!

Want to know more about Medicaid? {link-quiz-medicaid}

Medicaid is a government program for low-income families, pregnant women, the elderly, and people with disabilities. It covers millions of Americans and is one of the largest payers for health care in the United States.

Medicare is:

Correct!

Want to know more about Medicare? {link-quiz-medicare}

Medicare is a federal health insurance program for people aged 65 or older and for certain younger people with disabilities. It is divided into four parts (A, B, C, and D). Each part offers a unique type of coverage.

If I don’t have health insurance, I might be able to afford my medication with the help of:

Correct!

Want to know more about what do do if you don’t have health insurance? {link-quiz-uninsured}

All of these programs may help you afford your medication if you are uninsured. Ask your doctor for even more potential resources. And be sure to check out these {link-quiz-programs}.

Gabby, way to go!

You finished—great job!

You finished—great job!

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