High or Low Deductible? Choosing Your Medical Insurance

Photo of couple looking at a website on a laptop for information on North Carolina insurance deductibles from Hunt Insurance of Raleigh.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.

High deductible

  • 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.

Low 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.

Affordable Care Act – Obama Care Enrollment Deadline

The Affordable Care Act (ACA / Obama Care) enrollment deadline date is January 15, 2016 at 11:59 Pacific Time.  The broader deadline to avoid paying a fine for not having health insurance is January 31, 2016. Although you’re not required to sign up, if you don’t, you’re subject to a fine. Depending on your circumstances and income, penalties can range from several hundred dollars to more than $1000.

If you’ve already enrolled, and you’ve done so before December 17, 2015, your coverage is effective January 1, 2016.

Having Trouble Deciding Which Healthcare Plan to Choose?

Picture of a man working on a laptop for Raleigh ACA Obama Care health insurance help from Hunt Insurance.If you’re like many people, you have put off enrolling in health insurance because you’re not sure what to choose or how to work your way through the Healthcare.gov website. We can help.

Remember, the Healthcare.gov website is for people who don’t have medical insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source. This means that you are able to explore your options through an insurance carrier or an insurance agent.

The assistance of an experienced professional can simplify the process for you. You will be able to compare plans, costs, and decide which plan is best for you and your family.

Health Insurance – Some Factors to Consider

  • What does the plan cover? – Find out if the plan covers services such as doctor’s visits, hospitalization, prescriptions, physical therapy, emergency care, orthopedic services, and other care you need or expect to need.
  • Which providers can you see? – Many plans require you to go certain doctors or hospitals. If you go to a medical provider outside of the plan’s network of doctors, you will have greater out-of-pocket costs. Or you may be responsible for the entire costs.
  • What are your co-pays and deductibles? – Determine how much you will have to pay for doctors visits, prescriptions, and other care. Will you have to pay a certain amount of medical expenses on your own before the plan starts to provide benefits?
  • What about out-of-state care? – If you travel out of the state or out of the country, find out what your plan will pay if you need medical care.

There is a lot to consider, but an insurance professional can help you understand your options. Get assistance now to avoid ACA/Obama Care penalties for failure to enroll.

This post is sponsored by Hunt Insurance of Raleigh, NC.