Health insurance helps you manage the high costs of health care. It helps you pay for doctor visits, hospital stays, prescription drugs and preventive care.
You can choose from a variety of health insurance plans that fit your budget and have different levels of coverage depending on your needs.
A health plan example
Let’s say you’ve had a serious accident. Your medical bills are $50,000. Your health insurance plan makes a huge difference in the amount you’ll pay.
Sample health plan
- Annual deductible: $5,000
- Coinsurance: 20%
- Annual out-of-pocket maximum: $6,000
How it works
- In this example, you pay the first $5,000 in medical costs (your deductible) before your plan starts paying.
- After that, you’re responsible for 20 percent of costs until you reach the out-of-pocket-maximum. In other words, you only pay $2 of every $10 in covered expenses until you reach the $6,000 out-of-pocket-maximum.
- Your health plan then pays the rest of your covered costs for the year, no matter how high they are.
What you’ll pay in this example:
- Total $50,000
- You pay: $6,000 maximum
- Your health plan pays: $44,000
Health insurance definitions
Copay: A set price for some health care (for example, $25 per office visit). Some plans don’t have a copay.
Covered costs: Medical tests, treatments, supplies, medications and other health care paid for by your health plan. Check your health plan materials for details about what’s covered by your plan.
Deductible: The amount you pay for medical costs each year before your health plan begins to pay.
Coinsurance: The costs you and your health plan share. For example, you pay 20 percent of the cost of a doctor’s office visit or hospital stay, and your plan pays the other 80 percent. Some plans do not have coinsurance.
Health savings account: Pre-tax contributions to your HSA account can help you save when you use it to pay for covered costs.
Out-of-pocket maximum: The most you have to pay for covered medical costs in a year.
Premium: The monthly amount you pay for your health plan. Usually a lower premium comes with a higher deductible.
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