Health insurance appeals
Separate a Marketplace eligibility appeal from an insurer claim appeal, then follow the notice, deadline, and official process. Open guide.
Coverage knowledge base
Health insurance guides built around official sources
Understand the question, collect the controlling records, and keep a dated decision file.
These guides explain the documents, official routes, and verification questions behind health coverage. They do not make eligibility, claim, tax, legal, or medical decisions for a visitor.
Start with the guide that matches the decision-maker: Marketplace, insurer, employer plan, Medicaid or CHIP agency, Medicare, or tax authority.
Coverage knowledge base
Find a topic
Children's Health Insurance Program (CHIP)
Use the official state process for children's coverage; eligibility rules, benefits, and administration vary by state. Open guide.
COBRA continuation coverage
Compare continuity, full premium, deadlines, Marketplace options, and Medicare coordination using the employer notice and official guidance. Open guide.
Health insurance deductibles
Map medical, drug, individual, and family deductibles to the services that actually use them. Open guide.
Family health plans
Compare household premiums, embedded cost sharing, pediatric needs, providers, prescriptions, and dependent rules. Open guide.
Prescription drug formulary
Verify the exact drug, dose, tier, pharmacy, deductible, and restrictions for each plan year. Open guide.
HMO and PPO verification
Use the labels to ask better questions about referrals, outside-network benefits, cost, and provider access. Open guide.
Individual health insurance
Find the official Marketplace, separate on- and off-Marketplace routes, and compare current plan documents. Open guide.
Marketplace and off-exchange coverage
Compare savings eligibility, enrollment channels, plan identity, ACA status, documents, and consumer protections. Open guide.
Medicaid coverage
Use the official state application and written notice; eligibility, benefits, and managed-care arrangements vary by state. Open guide.
Medicare coverage
Use Medicare.gov for eligibility, enrollment, Original Medicare, Medicare Advantage, Part D, and plan comparison. Open guide.
Medigap policies
Compare standardized plan letters, insurer price and service, enrollment timing, and state-specific rules using Medicare sources. Open guide.
Provider networks
Confirm exact doctors, facilities, laboratories, pharmacies, referrals, and out-of-area rules for the precise plan. Open guide.
Open Enrollment
Verify official dates, update household facts, compare the new plan year, and confirm activation. Open guide.
Out-of-pocket costs
Separate premiums, deductibles, copays, coinsurance, protected in-network spending, and excluded charges. Open guide.
Prior authorization
Identify who must request approval, what records are needed, the decision timeline, and the appeal route before scheduled care. Open guide.
Preventive care benefits
Verify the recommended service, eligibility criteria, network, billing context, and whether additional services create cost sharing. Open guide.
Lowering health plan premiums
Use official savings, compare the full plan design, and avoid trading away essential coverage without identifying the product. Open guide.
Short-term health coverage
Identify duration, exclusions, underwriting, limits, renewal, state availability, and alternatives before comparing price. Open guide.
Marketplace savings
Prepare household facts, use the official application, and keep the eligibility notice and updated plan result. Open guide.
Telehealth coverage
Verify the platform, provider network, service type, location rules, prescriptions, cost sharing, and privacy before a visit. Open guide.
Verification links
Primary sources
Decision hubs
Move from a broad question to a dated plan record
Affordable health insurance plans
Compare savings, total cost, network, prescriptions, and protection.
Best plan for your needs
Use hard requirements and an elimination method instead of a universal ranking.
Health insurance costs
Separate premium, deductible, service charges, prescriptions, and limits.
Major medical insurance
Identify the product and controlling documents before comparing price.
2027 Marketplace planning
Recheck the official route, dates, plan identity, costs, and access for the new plan year.