Frequently Asked Questions
What is a premium?
A premium is the monthly cost of keeping your insurance policy in effect. Health insurance
premiums are determined by a variety of factors, including your medical history, your
lifestyle, and your current health status.
What is a deductible?
A deductible is an amount of medical expenses you are responsible for paying before your
insurance starts covering you. A common deductible is $500. This means you would be
responsible for paying the first $500 in medical bills before receiving coverage. Having a
higher deductible usually means you enjoy lower monthly premiums.
What is a co-payment?
A co-payment is a fixed-dollar amount that you are responsible for paying for a particular
medical service. For example, many plans have $20 co-payments for doctor's visits. This
means it only costs you $20 to see a doctor.
What is coinsurance?
Coinsurance is an amount of the cost of a medical service that you are responsible for
paying. Unlike a co-payment, which is a fixed-dollar amount, coinsurance is expressed as a
percentage. For example, many insurance plans have 20% coinsurance for hospital costs,
meaning you pay 20% of the total cost of a trip to the hospital.
What is an out-of-pocket expense?
An out-of-pocket expense is any cost you have to pay yourself when receiving medical care.
This includes your deductible, co-payments, and coinsurance. Most health insurance
policies have an annual maximum out-of-pocket expense. Once you’ve paid out enough
money to meet that maximum, your insurance company will pay the rest of your medical
costs.
What is managed care?
Managed care is a form of health insurance that stresses preventive medicine and
affordability. In a managed care plan, you typically choose a Primary Care Physician who is
responsible for approving specialist and hospital care. Managed care was originally
introduced as a way to control healthcare costs. It's now the most common form of health
insurance in the United States. HMOs and PPOs are examples of managed care.
What is a Health Savings Account?
Health Savings Accounts aren't health insurance plans. Instead, they are a financial tool
designed to help make your healthcare more affordable. The money you deposit in an HSA
is tax-free. You don't pay taxes on qualified withdrawals, either. In effect, it's like getting extra
money from the government to pay for healthcare. To open an HSA, you first have to
purchase a high deductible health insurance plan.
Why should I buy health insurance?
Having health insurance isn't just about paying medical bills. It's about knowing that you'll
always have access to quality care. Health insurance makes seeing the doctor easy and
affordable, and that means you're more likely to stay healthy.
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