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  • Marketplace/Exchange

    State Health Insurance Marketplaces (also called Exchanges) are websites where you can get information about health insurance, see a variety of insurance options, compare plans, and purchase insurance. Depending on whether or not your state chose to run to its...

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  • Essential Health Benefits

    Basic categories of benefits that must be provided by plans on the new state Health Insurance Marketplaces, individual and small group plans not on the state marketplaces, and state Medicaid plans. These categories of services include: ambulatory services; emergency services;...

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  • Deductible

    The amount you pay for care before your insurance kicks in. For example, if you have a $1,000 deductible, you will pay $1,000 before your insurance covers health care costs. There can be another deductible for a specific benefit like...

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  • Cost-sharing subsidies

    A discount on your out-of-pocket costs, such as your co-pay. Depending on your income level, if you buy a “silver” plan on the state marketplace, you may be eligible for a cost-sharing subsidy. A silver plan is a type of...

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  • Co-pay

    A co-pay is the flat fee you have to pay for a service, such as a doctor’s visit or a prescription. If you have a $15 co-pay for visits to your primary care provider, you will pay $15 for a...

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  • Co-insurance

    The amount of cost sharing between you and your insurance company. If you have a 80% / 20% co-insurance, this means that when you receive care, the insurance company pays 80% of the cost and you pay the other 20%.

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  • Catastrophic Plan

    A plan with a low monthly premium but high out-of-pocket costs and a very high deductible.  You must be under 30 years old or eligible to get a “hardship exemption” because you can’t find other affordable health insurance coverage in...

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