Getting covered

Medical Care can be very expensive, and most families cannot pay for all the costs on their own. Health insurance pays for a portion of the covered medical costs and may negotiate less expensive rates with physicians or hospitals. In order to receive these benefits, you must pay a premium each month.

When you buy a health insurance plan you join a pool of people that are also covered by the same insurance plan. An insurance company collects a premium from all people in the pool which will be used to pay for the health benefits.  Some years you may need more medical care than others, but a health insurance plan is there to help you share the high costs of insurance.

When you have health insurance, you share the cost of healthcare services with your insurance provider. Each plan will have out-of-pocket costs for services that you will pay in addition to your monthly premium.

Out-of-pocket costs include a combination of:

Copayment:A fixed amount (for example, $15) you pay for a covered healthcare service, usually when you get the service. The amount can vary by the type of covered health care service. Can be referred to as a copay

Deductible:The amount you owe for covered healthcare services before your health insurance plan begins to pay. For example, if your deductible is $1,000, your plan won’t pay anything until you’ve paid $1,000 for covered services. Some plans pay for certain health care services before you’ve met your deductible

Coinsurance:Your share of the costs of a covered healthcare service, calculated as a percentage (for example, 20%) of the allowed amount for the service. You pay coinsurance after you’ve met your deductible. For example, if the health insurance plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your 20% coinsurance payment would be $20. The health insurance plan pays the rest

Types of Health Insurance plans:

There are many different types of insurance plans. Each plan has different coverage, meaning that it may pay for just emergency coverage or general wellness care (such as a check up at the doctor’s office).  In order to choose the right insurance plan for your family, you must should find a plan that includes the best balance of coverage and out-of-pocket costs to fit your family’s needs.

Insurance Plans can be divided into Public and Private Insurance Plans:

Public Insurance Plans include programs such as Medicaid or Medicare

Private Insurance Plans include insurance plans that you may be eligible for with your employer or through the Health Insurance Marketplace, established under the Affordable Care Act.

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