Health Insurance 101

HEALTH INSURANCE 101

Health Insurance can be confusing.. and expensive! There are so many different elements about your policy you need to be aware of. So let's start with the basics; what you owe!

1. Premium: This is the amount you pay into your insurance policy monthly. Typically, if you receive your insurance through your employer they cover a portion.

2. Deductible: This is the amount you must pay out of pocket before your insurance will cover your claims in full minus your co-pay (more on that in a moment!) Each plan's deductible is different, and most plans include individual and family deductibles so read carefully!

3. Co-pay: Your co-pay is the amount you pay up front for a service. This is not limited to only sick visits at your doctor. Your plan may carry co-pays on prescriptions, imaging appointments, physical therapy, mental health visits.. you may even have a co-pay for your annual wellness visit! Your co-pay amount should be listed on the front of your card and some plans have tiered co-pay amounts. Check with member services before a visit to verify which tier the provider falls under. Also, providers have no control over which tier they are assigned.. so be kind at check in if your co-pay is higher than expected!

4. Co-insurance: This is one that sneaks up on people. Some plans have co-insurance, which means you are responsible for a certain percentage of the contractual rate. Yes, that means even after your premium, deductible and co-pays you still may owe co-insurance on top of that.

5. Out-Of-Pocket Limit: You're probably thinking "At what point does my insurance actually cover something in full?!" Well it's when you hit your Out-Of-Pocket Limit, which most people never hit unfortunately.

But there are ways to be conscious of how much you are spending on your health insurance plan and costs. Follow along as we continue to break down the ins and outs of health insurance!