Just a quick look shows that it basically happens when your hormones are wacky. BCP, pregnancy, and assumingly PCOS can all trigger this, because I know my PCOS can be as unpredictable hormonally as those other two...

I don't think that I would be super concerned overall, but I would focus on getting your hormones balanced - dropping sugar (spikes insulin makes other hormones wacky), working out (balances out spikes), and supplementing (inositol or vitex or something to balance out hormones, etc.)... If that doesn't help, or if you have an outside concern, then I'd get checked out, insurance or not...

Wow, I just went back and looked at some pictures, @littlefish0128 - this is what I have on the sides of my face. I recently moved and spent a lot of time driving and moving about in the sun...and essentially the part of your face that on a man would be between the sideburns along the edge of the face towards the chin, where the beard would be, I developed this - melasma - in that area. If I'm not mistaken, this is what Brooke Burke suffers from as well. I never had this until August, but I've always had slight shadowing in areas where skin touches other skin, so under the breasts, armpits, neckline, inner elbows, etc. I forget what it is ... Acanthosis nigricans (AN). I thought it was that. But the jawline stuff I have DEFINITELY looks like Melasma far above the other options. And I know my hormones were all wacky during that time, because my insulin was out of whack, too, and they go together, and plus I started spotting from all the stress out of nowhere, and I take preventative continuous pills... So wow...