How much does health insurance cost? Learn about deductibles, premiums, copays and other health insurance costs in this informative article from Medical Mutual.
In almost any area of your life, if you don’t have a clear idea of your expenses, you may feel like you’re not in control. But, when you get clear about all the costs, you feel in control, helping you make the right choices.
To get a clear understanding of your health insurance costs, the first step is to look at all the key types of costs, not just obvious expenses. It’s a lot like adding up your automobile expenses – some of the clear costs include your car payment, insurance, gas, oil changes and repairs. Less obvious costs include the finance charge on your payment, windshield wiper fluid and parking tickets.
Let’s take a look at obvious health insurance costs and some examples.
Your health insurance plan premium is an obvious cost, and most people pay it on a monthly basis. Your premium is the payment you make to your health insurance company that keeps your coverage active. Other more obvious health insurance costs include deductibles, coinsurance and copayments. You may already be familiar with some of these terms. Here are quick definitions and simple examples.
What is it?
Here's an example...
Premium
A premium is the amount of money charged by your insurance company for the plan you’ve chosen. It is usually paid on a monthly basis, but can be billed a number of ways. You must pay your premium to keep your coverage active, regardless of whether you use it or not.
You’ve researched rates and the health plan you’ve chosen costs $175 per month, which is your premium. In order to keep your benefits active and the plan in force, you’ll need to pay your premium on time every month.
Deductible
A deductible is a set amount you have to pay every year toward your medical bills before your insurance company starts paying. It varies by plan and some plans don’t have a deductible.
Your plan has a $1,000 deductible. That means you pay your own medical bills up to $1,000 for the year. Then, your insurance coverage kicks in. At the beginning of each year, you’ll have to meet the deductible again.
Coinsurance
Coinsurance is the percentage of your medical bill you share with your insurance company after you’ve paid your deductible. Unless you have a policy with 100 percent coverage for everything, you have to pay a coinsurance amount.
You have an “80/20” plan. That means your insurance company pays for 80 percent of your costs after you’ve met your deductible. You pay for 20 percent.
Coinsurance is different and separate from any copayment.
Copayment (or "copay")
Your copayment, or copay, is the flat fee you pay every time you go to the doctor or fill a prescription. It’s usually a relatively small dollar amount. Copays do not count toward your deductible.
Let’s say your plan has a $20 copayment for routine doctor’s visits. That means you have to pay $20 each time you go. Copayments are different than coinsurance.
Like any type of insurance plan, there are some expenses that may be partially covered, or not at all. You should be aware of these expenses, which contribute to your total healthcare cost. Less obvious expenses may include services provided by a doctor or hospital that is not part of your plan’s network, plan limits for specific kinds of care, such as a certain number of visits for physical therapy per benefit period, as well as over-the-counter drugs.
To help you find the right plan that fits your budget, look at both the obvious and less obvious expenses you might expect to pay. Here are some tips for calculating your total health insurance cost:
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