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The Affordable Care Act’s health insurance mandate was lifted but the following states still require health insurance to avoid a tax penalty: California, Massachusetts, Washington D.C., New Jersey and Rhode Island. In Vermont, health insurance is required without a penalty.

HMOs generally won't cover out-of-network care, and you’ll need a referral from a primary care physician to see a specialist. A Preferred Provider Organization (PPO) health plan will cover you only partially if you go outside the plan’s network or see a specialist without a referral. An Exclusive Provider Organization (EPO) is a managed care plan that also requires members to use the plan’s network, which is larger than an HMO’s. Premiums cost a bit more than an HMO plan but still less than a PPO plan. In a Point of Service (POS) plan, you pay less if you use health care providers in the plan’s network with a referral from a primary physician to see a specialist. You also pay your medical bills first before filing a claim for reimbursement from the insurance carrier.

Most health insurance plans do not cover optometrist visits and glasses, but you may be covered to see an ophthalmologist, who can take care of eye diseases and write you a prescription for glasses. Your frame and lenses will not be covered unless you have a separate vision plan. Similarly, you may need a separate dental plan for checkups, cleanings and dental work. You may be partially covered for oral surgery with your health insurance plan and partially with your dental insurance plan. You may also need a separate plan for hearing.