GOOD HEALTH: is wanted by all, but things happen and the high cost of doctors and hospitals can be a real burden, financially, if not protected by an insurance policy. With the passing of the Affordable Health Care Act, lots of information has been available to the public and it can be very confusing and frustrating when trying to see what meets your needs. The staff at our agency attended several webinars and company meetings to get certified, so we will be able to review options that might be of your interest. The intent of the Act is to do most of the research and sign up via computer, and we are here to assist those in need. Please contact us if you are looking for assistance with your health insurance.
PREMIUMS: Your premium is the amount you pay to the health insurance company each month to maintain your coverage. When trying to understand the cost of health insurance plan, the premium is the first thing to consider. Make sure to balance it against other costs, such as copayments, deductibles and coinsurance. A good rule, choose a lower premium/higher deductible if you want to save money now, and a higher premium/lower deductible if you want to be more financially prepared for unexpected medical expenses later.
DEDUCTIBLE: Your annual deductible is the amount you will be required to pay out-of-pocket before the insurance company will begin paying for your medical claims. Keep in mind, your monthly premiums and copayments will often not count toward your deductible. Keep in mind that a plan with a higher deductible will keep your monthly premiums lower.
COINSURANCE: This is the percentage of the bill the insured is responsible for after the deductible has been reached until you have satisfied your maximum out-of-pocket limit. For example, if you have an 80/20 plan, with a $1000 deductible, and a $2000 out-of-pocket maximum, once you reach your $1000 deductible, you pay 20% of all bills, until you pay an additional $1000 out-of-pocket, then after that everything is covered at 100%.
COPAYMENT: Your copayment, or "copay" is the specific dollar amount you may be required to pay up front for a specific type of service, or a prescription drug.
MAXIMUM OUT-OF-POCKET: This is the maximum amount the insured is responsible for in a calendar year. Once you have paid out-of-pocket to the "maximum" amount (typically through deductibles, copayments or coinsurance), the insurance company pays the full charges for any additional covered medical services rendered that year. Your monthly premium will not count toward your maximum out-of-pocket costs.