Key insurance terms that start with "T"

A tobacco surcharge is an additional premium charge that health insurers can apply to people who use tobacco products. Under the ACA, insurers are allowed to charge tobacco users up to 50% more than non-tobacco users for the same plan — making it one of the few health-related factors that can legally affect your premium on an individual market plan.

A few important things to know:

• The surcharge applies to cigarettes, cigars, chewing tobacco, and other tobacco products. E-cigarettes and vaping may or may not be included depending on the insurer and state.
• Not all states allow the tobacco surcharge. Some states (including California, Massachusetts, New York, Vermont, and others) have prohibited it entirely.
• Premium Tax Credits cannot be used to offset the tobacco surcharge — you pay it fully out-of-pocket even if you qualify for subsidies.
• You self-report tobacco use when applying. Insurers may ask about frequency and recency of use.

If you’re working to quit, some plans offer tobacco cessation programs at no cost as part of preventive care benefits.

Short-term temporary coverage to bridge gaps between jobs or insurance plans. Transitional coverage typically lasts a few weeks to a few months and provides basic protection. It's less comprehensive than permanent insurance but useful when you're between plans.

Your total monthly premium is the full cost of your health insurance plan before any subsidies are applied. It’s the sticker price your insurer charges for coverage each month.

Most people on the ACA Marketplace don’t pay the total monthly premium directly. If you qualify for an Advance Premium Tax Credit (APTC), that credit is applied to your bill automatically, and you only pay the difference. The total monthly premium is still important to know because:

• It determines your subsidy calculation (the government subsidizes based on benchmark Silver plan pricing in your area)
• If your income rises above your subsidy eligibility, you may owe the full amount
• It’s the figure used when comparing plans before subsidies are factored in

When shopping on the Marketplace, always look at both the total monthly premium and your net premium after subsidy. A plan with a high total monthly premium may end up cheaper than one with a lower sticker price if it attracts a larger subsidy.

Telehealth (also called telemedicine) refers to health care services delivered remotely using technology — video calls, phone consultations, or secure messaging with a licensed provider. You receive medical care from home (or anywhere with an internet connection) without going to a clinic or hospital.

Under the ACA, most Marketplace plans and employer plans cover telehealth services. Coverage expanded significantly during the COVID-19 pandemic, and many insurers maintained broader telehealth benefits afterward. However, coverage rules vary by plan, state, and service type.

Telehealth is commonly used for:

• Primary care visits and sick visits
• Mental health therapy and psychiatric consultations
• Prescription renewals for non-controlled medications
• Chronic disease management (diabetes, hypertension, asthma check-ins)
• Dermatology consultations via photo or video
• Nutritional counseling and wellness coaching

Telehealth visits are typically cheaper than in-person visits — many plans offer lower copays for telehealth, and some preventive telehealth services may be covered at $0. Confirm your plan’s specific telehealth copay and coverage before booking.