Using your coverage once it starts

Coverage isn't only for when you're sick

Once your coverage starts, you can use it for prescriptions at the pharmacy, visits to the doctor, and emergency care. Preventive visits and screenings are part of it too, so using your plan while you feel well is how you get the most from it.

Stay in network when you can

Your plan has contracts with certain doctors, hospitals, and other providers. That's your network. Seeing an in-network provider usually means you pay less. You may be able to see providers outside the network, but you'll usually pay more.

How to check whether a doctor is in your plan

• Look up your plan's provider directory on the insurance company's website, or through the link on your plan in your Marketplace account.
• Call your insurance company. The number is on your insurance card.
• Call the doctor's office and ask whether they take your specific plan, not only your insurance company.
• Call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) if you need help finding your insurer's number.

If your plan won't pay

If your plan denies a claim or refuses to cover a service, you have the right to appeal. That includes finding out after a visit that your regular doctor isn't covered. You can have the decision reviewed by an independent third party.

Have Medicaid or CHIP?

Medicaid and CHIP (the Children's Health Insurance Program) work a little differently. HealthCare.gov has a separate page on using new Medicaid or CHIP coverage, linked in the sources below.