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Individual + family plan FAQs
Get answers to common questions about health insurance plans for individuals and families. Find out about benefits, coverage, financial information, and more.
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When it comes to individual and family health plans, there's a lot to consider. We've pulled together all our resources in one place to help you figure out:
- How insurance works
- Coverage and benefits
- Plan Types
- Enrollment periods
- Helpful terms
You can search for the doctors, specialists, and other providers covered by your specific plan.
Check out the programs and services covered by your specific plan.
You’ll have to decide based on how you’re feeling. We can make that choice a little easier.
Medication coverage varies by plans. Sign in to review the list of drugs covered by your plan.
Every health plan has a network of providers, clinics, pharmacies, and hospitals. When you pick a plan, you’re choosing your network. Your coverage depends on your provider being in your network.
Some of our individual and family plans have three tiers of network providers. You’ll receive different levels of coverage based on your provider’s tier.
Sign in to see which wellness programs are offered for your specific plan. Or view our general wellness offerings.
This booklet includes important information to help you decide how to best use your health insurance benefits and how to file a complaint or appeal, if you need to.
Benefits + coverage
It’s a document that explains who, when, and how much you may need to pay for health care services. It’s not a bill, but it does include a summary of services you received and how your plan covers them.
It provides an overview of important information about your plan’s benefits and coverage.
Your deductible is the amount you pay each year before your insurance starts to pay. A copay is flat fee you pay for some services and prescriptions. Copays apply to your out-of-pocket maximum, not the deductible. Coinsurance is a percentage of the charges for a health care service that you pay.
We’ve broken down all the parts of your invoice to make it easy.
You can make payments online.
The process can vary depending on your provider’s networks status and the type of claim you’re filing. You typically won’t have to file a claim — providers usually do it. But if you ever need to file one, we’ve made it easy to figure out how to do it.
Many people who buy individual insurance can get a subsidy to help pay premiums and out-of-pocket costs. To get a subsidy, you have to buy your plan through your state's health insurance marketplace.
Additional plan details
Here’s how to understand all the parts of your ID card.
We’ve pulled all our forms together to help you find what you need.
Every state has unique rules about how you can file a health insurance claim appeal. If you live in Arizona, this packet explains everything you'll need to know such as, who can file an appeal, how to send it in, and how long a health insurance company has to make a decision.
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Health plan info guides
Starting a new family
Make sure to protect your loved ones with a health care plan.