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By 2014, uninsured adults will be eligible for health insurance through exchanges with multiple plan options. Choosing health insurance is challenging even for those who have engaged in the process previously. We examined 51 uninsured adults’ health insurance knowledge and preferences through semistructured qualitative interviews. Our sample was predominantly low-income and African American. Most had little or no experience with health insurance terminology. Those with limited health literacy skills understood less than those with higher health literacy. Many confused related insurance concepts. Non-health contexts (e.g., car insurance) aided understanding. Premiums, fixed costs, and specific coverage were rated very important to insurance decisions. Our study was one of the first to examine uninsured individuals’ health insurance knowledge and preferences. Uninsured individuals may have different …