How to Identify False Statements About Health Insurance: A Comprehensive Guide for Students and Families

By Jessica WrightLast Updated June 27, 2025

Understanding Health Insurance: What You Need to Know

Health insurance plays a critical role in protecting individuals and families from the high cost of medical care. Yet, misconceptions about how it works are widespread, sometimes leading to poor decisions or gaps in coverage. This guide empowers you to distinguish between true and false statements about health insurance and offers actionable advice for making sound choices, as emphasized in educational resources like EVERFI’s Healthcare Literacy curriculum [1] .

The Importance of Health Insurance Literacy

Health insurance literacy means understanding the terms, benefits, and limitations of your coverage. Without this knowledge, people risk incurring unexpected expenses, receiving denied claims, or lacking essential care. Educational programs, such as those provided by EVERFI, encourage students and families to build this literacy to make informed decisions and avoid financial hardship [1] .

Common Statements About Health Insurance: Which Are True and Which Are False?

Many people encounter statements about health insurance that may or may not be accurate. Here, we break down some frequently seen claims and clarify their validity.

Statement 1: “Health insurance covers all your medical expenses.”

This statement is false. Even the most comprehensive health insurance plans require members to pay certain out-of-pocket costs, such as deductibles, copayments, and coinsurance. Additionally, some services, providers, or medications may not be covered by your plan. To avoid surprises, review your policy documents carefully and ask questions about coverage limits and exclusions before seeking care. For further information, consider reviewing your plan’s summary of benefits or contacting your insurer directly.

Statement 2: “You can only get health insurance through your employer.”

This statement is false. While many people obtain health insurance through their employer, there are multiple other options. These include purchasing a plan through the Health Insurance Marketplace, enrolling in government programs like Medicaid or Medicare (if eligible), or buying individual plans directly from insurance companies. For step-by-step guidance, you can search for ‘Health Insurance Marketplace’ or visit the official Healthcare.gov website.

Statement 3: “You must wait for open enrollment to buy health insurance unless you qualify for a special enrollment period.”

This statement is true. In most cases, individuals must sign up for health insurance during the annual open enrollment period. However, qualifying life events-such as losing other coverage, getting married, or having a baby-may trigger a special enrollment period, allowing you to sign up outside the regular window. If you believe you qualify, contact the Health Insurance Marketplace or your state’s insurance exchange for more details.

Statement 4: “Having health insurance means you never have to pay out-of-pocket for medical care.”

This statement is false. Health plans typically include out-of-pocket expenses such as deductibles, copays, or coinsurance. Once you reach your out-of-pocket maximum for the year, your plan will cover 100% of covered services, but until then, you are responsible for a portion of the costs. For specifics, review your plan documents or speak with your insurer’s customer service department.

Statement 5: “Health insurance is only necessary if you are sick or have ongoing health problems.”

This statement is false. Health insurance is important for everyone, regardless of current health status. Accidents and unexpected illnesses can happen to anyone, and having coverage ensures access to care and protects against high medical bills. Educational resources like EVERFI’s curriculum stress the importance of planning ahead and understanding the risks of being uninsured [1] .

How to Evaluate Health Insurance Information

Learning to critically assess statements about health insurance is vital. Here are steps you can take to determine whether a claim is reliable:

Check the Source: Reliable information comes from established organizations, official government agencies, or trusted educational platforms such as EVERFI.
Look for Details: Vague statements or promises that sound too good to be true often signal misinformation. Seek clear explanations of coverage, costs, and limitations.
Compare Policies: Use official documents like the Summary of Benefits and Coverage (SBC) to compare plans and verify what is included and excluded.
Ask Questions: If you are unsure, contact your health insurance provider, a licensed agent, or a health navigator for clarification.
Use Official Sources: For U.S. health insurance, visit Healthcare.gov for individual and family plans, or check your state’s official health exchange.

Accessing Health Insurance: Step-by-Step Guidance

If you are seeking coverage or want to learn more, follow these steps:

Assess Your Options: Identify whether you qualify for employer-sponsored insurance, Medicaid, Medicare, or need to buy an individual plan. If you are unsure, visit the official Healthcare.gov website or search for your state’s health insurance exchange.
Gather Documentation: Prepare information such as income, household size, and citizenship status, as these details are often required for applications.
Apply During Enrollment: Most plans require enrollment during a specific period. Mark open enrollment dates on your calendar. If you experience a qualifying event, research special enrollment period rules by searching for ‘special enrollment period’ on Healthcare.gov or at your state exchange.
Compare Plans: Carefully review each plan’s coverage details, costs, provider networks, and benefits. For help, use plan comparison tools on Healthcare.gov or contact a licensed insurance agent.
Get Help if Needed: If you need assistance, look for local health navigators or certified application counselors. These professionals can answer questions and help you complete your application. Contact information is available through Healthcare.gov or your state’s insurance portal.

Overcoming Challenges and Avoiding Misinformation

People often struggle with insurance jargon, unclear coverage, and changing regulations. Here are practical solutions:

Use Glossaries: Most official health insurance sources provide glossaries to explain terms. Reviewing these can clarify the meaning of deductibles, copayments, coinsurance, and more.
Attend Workshops: Many community centers, libraries, and schools offer workshops on health insurance literacy. EVERFI’s Healthcare Literacy curriculum is an example of a resource designed to demystify insurance concepts for students and families [1] .
Stay Informed: Health insurance rules can change. Subscribe to newsletters from official sources or check updates on Healthcare.gov to remain current.

Alternative Approaches to Understanding Health Insurance

If you prefer self-paced learning or want to supplement your knowledge, consider these alternatives:

Online Courses: Search for free or low-cost health insurance literacy courses provided by educational nonprofits or your local community college.
Consult Trusted Advisors: Reach out to healthcare providers, social workers, or school counselors for personalized advice.
Read Official Documents: Always read the policy documents and official communication from your insurer.

Key Takeaways

Not all statements about health insurance are true; it’s essential to verify facts using reputable sources.
Health insurance does not cover every expense, and coverage varies by plan.
Multiple pathways exist for obtaining health insurance, not just through employers.
Building health insurance literacy protects you from misinformation and costly mistakes.
Use official resources and ask questions to ensure you fully understand your options and responsibilities.