Health insurance has become more accessible, but also a lot more complicated. When it’s time to select your health plan, you need to consider several factors to determine the true cost of competing plans:
- Premium — this is the monthly fee you pay to belong to the plan. Basically, this is the cost of belonging to the plan.
- Deductible — this is the total amount you will have to pay before you see any insurance benefits. With most plans, you must pay your entire deductible to providers before your insurer starts making payments.
- Copayment — this is a set fee you will need to pay for every office visit and prescription.
- Co-insurance — this is the amount of medical costs you will have to bear after exhausting your deductible. For example, your insurer might pay 80 percent, and you will have 20 percent co-insurance.
- Out-of-pocket limit — Most plans set a yearly maximum out-of-pocket limit, and once you reach that figure the plan will cover all approved medical expenses.
- Out-of-network costs — Most plans have networks of preferred hospitals, doctors, labs, therapists and other providers. If you use a facility or service in the network, you will have more of your costs covered (after copayments and the deductible). If your health providers are not in the network, however, it could cost you more to continue to use their services.