understanding health plan terms such as premium, deductible, co-payment, coinsurance and out-of-pocket maximum is important to understand the costs of your health care. How to evaluate your health plan options, here is a list of common terms on the cost of health insurance.
Health Plan Costs
Premium
, the amount, you (or your employer) pay for your plan to the insurance company, usually monthly.
deductible
to pay the amount you pay for covered care starts before your health insurance. For example, you can $ 500 out-of-pocket for covered services before the insurance pays not pay. This would a $ 500 deductible.
co-payment
A set dollar amount you pay to your doctor for a covered service. For example, you can pay a $ 30 co-pay for each covered visit to a general practitioner. Or you can pay a $ 15 co-pay for each generic pharmacy products.
co
pay the share of allowable charges for covered services that you needed. For example, the health insurance covers 80% of the fee for a covered hospital stay, leaving you responsible for the remaining 20%. This 20% is known as the co-insurance. If the plan has a deductible, you pay coinsurance for covered services after the deductible is met.
Out-of-pocket maximum
The maximum amount of money that you will for covered services during a benefit period, such as paying a year. This financial responsibility can plan vary by plan, but can co-payments, deductibles and co-insurance. In Medicaid and CHIP, the boundary includes premiums
Category of Coverage
There are four basic steps-plan coverage are. Platinum, gold, silver and bronze. Since the metal levels go up in value, so does the percentage of medical expenses cover the health plan. There are also catastrophic plans available to some people
Source :. Zane Benefits Guide to individual health insurance
premium tax credits
premium tax credits are purchased to authorized persons for plans by the individual health insurance marketplaces. Households with incomes between 100% and 400% of the FPL, the coverage by national health insurance purchase market, are entitled to an insurance tax, to reduce the cost of the premium. To be eligible, you may not be affordable, qualified health insurance offered by employers. . See: How to premium tax credits for qualifying
cost sharing Reductions
Further discounts for some people are available, the lower the amount you out of -Pocket to pay for deductibles, co-insurance and co-payments. You can obtain this reduction, if you get health insurance through the health insurance market, your income is (250% of the FPL), and select at a certain level a health plan from the Silver plan category. If you are a member of a federally recognized tribe, you may qualify for benefits additional cost sharing.
What questions do you have about the health plan costs and conditions?
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