Health Insurance Basics

The story: Alex’s Saturday ankle

At a Saturday soccer game, Alex holds a sore ankle while Maya points to an insurance card.

1. Narrator: Saturday soccer. Alex lands wrong. The ankle swells, and it hurts to stand.
2. Alex: Is this an ER thing or an ice-it-at-home thing? I can’t tell.
3. Narrator: If it might be an emergency, call 911 or go to the ER. ERs must check and stabilize you, even if you can’t pay.
4. Maya: For things that clearly aren’t emergencies, there’s urgent care. Your insurance card says which ones are in network.
5. Narrator: In-network places have deals with your plan, so they usually cost less. The card has a number to call with questions.
6. Narrator: Might be an emergency? Go. Everything else: know your network.

What you’ll learn

1. Emergencies come first

   If it might be an emergency, call 911 or go to the ER. Emergency rooms must screen and stabilize you, even if you can’t pay. Rules also protect you from many surprise bills for emergency care.

2. Know your card and network

   Your insurance card shows your plan, your member ID and a number to call. In-network doctors and clinics have deals with your plan. They usually cost less than out-of-network ones.

3. Where to go when it’s not an emergency

   Primary care is for checkups and ongoing care. Urgent care handles things like sprains and small cuts when a doctor’s office is closed. Preventive care, like checkups and many vaccines, is usually covered.

4. Coverage and help

   You can usually stay on a family plan until 26. Medicaid and CHIP cover many teens. Plans are sold during open enrollment. Your out-of-pocket maximum caps what you pay in a year for covered care.

Key words

network

the doctors and places that have a deal with your plan

Also called: in-network and out-of-network

out-of-pocket maximum

the most you pay in a year for covered care

urgent care

walk-in care for problems that aren’t emergencies

open enrollment

the yearly window to sign up for or change a plan

Common questions

What if I can’t pay for the ER?

Go anyway if it might be an emergency. ERs must screen and stabilize you even if you can’t pay. Afterward, you can ask about financial help and payment plans.

What if my family has no health insurance?

Many teens qualify for Medicaid or CHIP. The fact card links to where families can check and apply.

Remember this

Might be an emergency? Go. Everything else: know your network.

Try it: Read an insurance card

1. Sample card (example): Sample Health Plan · Network: Sample Care Network · Member services: 1-800-555-0100.
2. Find the network name and the number to call, on the sample card or a family card.
3. Find one in-network urgent care, using the plan’s website or that number.

The whole mission; no account or app needed.

Live facts

Numbers that change over time, with when they were last checked and where they come from.

• Stay on a parent’s health plan until

  26

  Young adults can usually stay on a parent’s health plan until this age, even if they marry, leave school or move out

  As of February 8, 2026

  Source: HealthCare.gov(opens in a new tab)

• Open enrollment dates

  Source: HealthCare.gov(opens in a new tab)

• Medicaid and CHIP for kids and teens

  Source: HealthCare.gov(opens in a new tab)

• Protection from surprise medical bills

  Source: CMS.gov(opens in a new tab)