Are you exploring your options for health insurance or thinking about switching plans? It’s important to know what coverage each plan provides. You also need to understand plan deductibles and how they affect your wallet.
What Is a Deductible?
The insurance deductible is the amount you have to pay for medical care before your insurance plan pays toward the bill. For example, if your deductible is $2000, you must pay $2000 toward your medical and pharmacy bills before your insurance plan starts to pay for them. Some plans have certain medical services for which benefits are provided before you meet the deductible.
What Is Co-Pay?
Co-pay is usually a fixed amount that you pay a provider at the time you receive services. For example, your co-pay for a visit to your primary care doctor may be $25, and the co-pay for a medical specialist, such as an allergist may be $15.
What Is Co-Insurance?
Co-insurance is the amount that you are responsible for after your insurance plan pays its designated portion. For example, if your plan pays 70% of your hospital bills, you are responsible for paying the remaining 30% of the bill.
How Do You Decide?
Is it better to have a plan with a high deductible or a low deductible? Several things factor into that decision, and the answer depends on your health and your budget.
- Insurance plans with a high deductible have a lower monthly premium. Your monthly bill for insurance coverage will be lower.
- If you get sick or have an accident, you will have to pay more up front than with a low-deductible plan. If you frequently need medical care, you may quickly meet the deductible. If you are healthy, it will probably take longer to meet it.
- Keep in mind that some high-deductible plans provide limited services before you meet the deductible.
- The monthly premium, or cost, for your insurance coverage will be higher.
- If you experience a sudden illness or an emergency, your insurance plan will provide benefits sooner.
- Your co-pays or co-insurance for office visits, prescriptions or hospitals stays may be higher.
Before You Choose a Health Insurance Plan
Before you choose a health insurance plan, think about:
- Your budget
- The status of your, and your covered family members’, health
- The cost of the monthly premium
- The Deductible, and if you can afford it
- Co-pay amounts
- Co-insurance amounts
Speak with an experienced insurance agent to discuss your options for medical insurance and compare the plans.
This post is sponsored by Hunt Insurance of Raleigh.
We are an independent, African-American owned insurance agency.