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How Much Does the Plans Of Health Insurance Cost?
Introduction
We know health insurance companies do not always fully understand the evolving needs of people living with rare medical conditions. In this article, we will discuss the second question you should ask when choosing a health insurance plan. How much does the plan cost?
When calculating the cost of a plan it’s important to remember that there are two types of expenses associated with health insurance. The first is your monthly premium or the amount of money you pay upfront each month. The second is out-of-pocket expenses which are the fees you pay when you receive medical care.
In general, the higher the premium the lower your out-of-pocket expenses will be. Here’s how it works:
How it works
The monthly premium
Plans sold to individuals are divided into four tiers. Bronze, silver, gold, and platinum. Bronze plans have the lowest premiums but only cover 60% of the average member’s total health care costs. Silver plans cover 70%, gold plans 80%, and Platinum plans covered 90% of healthcare costs while having the highest premiums.
Of course, choosing which tier of insurance to buy depends on your specific needs. If you have an expensive medical condition as is the case with most rare diseases the gold or platinum plans would probably suit you better as they would cover more of your costs.
Out-of-pocket expenses
Out-of-pocket expenses also called cost-sharing or out-of-pocket costs refer to the portion of your medical bills which you are responsible for paying when you receive health care. Every plan is different when it comes to your out-of-pocket expenses.
So, be sure to compare the different plans on your state marketplace or ask your employer for a summary of benefits and coverage form. Out-of-pocket expenses can be paid in some combination of deductibles, co-pays, and coinsurance.
Deductible
Your deductible is the amount you must pay every year before your insurance company starts paying its share of the costs. If your deductible is $2000 then you would pay cash for the first two thousand dollars in health care you receive each year. After which the insurance company would start paying its share.
In every plan, preventive services will be covered in full even if you haven’t used up your deductible for the year. Some plans will also pay a part of your expenses for a few other services usually doctor visits and prescription drugs even before your deductible has been met.
This is more common with gold and platinum plans but some silver and bronze plans also cover some services before the deductible has been met. The only way to figure out whether a plan covers some services not subject to the deductible is to study its provisions very carefully.
Copay
Your copay is the fixed dollar amount you pay for certain types of care. You might pay $30 for a doctor visit and the insurance company will pick up the rest. Plans with higher premiums generally have lower co-pays and vice versa. Some plans do not have co-pays at all and use other methods of cost-sharing.
Coinsurance
Coinsurance is the percentage of the cost of your medical care that you have to pay. For an MRI that costs a thousand dollars, you might pay 20%, two hundred dollars. Your insurance company will pay the other 80 percent, $800. Plans with higher premiums generally pick up a larger portion of the bill.
On a final note, every insurance plan has an out-of-pocket limit which is the most cost-sharing you will ever have to pay in a year. It is the total of your deductible, co-pays, and coinsurance but does not include your premiums. Once you hit this limit the insurance company will pick up 100% of your costs for the remainder of the year.
Plans with higher premiums generally have lower out-of-pocket limits. The specifics of what an individual health insurance policy covers the cost of premiums the level of deductibles and the requirement for co-pays will all vary from policy to policy.
If your rare disease requires the care of specialized physicians and long-term therapy you want to choose a plan that helps you to be well and have access to that care. If you have any further questions or if you have some experiences in having health insurance share them with us in the comment below. Click here to read about how health insurance works and its best types.
FAQs
1. Can I get life insurance for my mother without her knowing?
When you are getting life insurance, the individual whose life will be insured is needed to sign the application and give consent. So, the answer is no.
2. What do you mean by insurance?
Insurance is a contract or policy in which an insurer indemnifies another against losses from specific contingencies or perils.
3. What is the disadvantage of whole life insurance?
The main drawback of whole life insurance is that you will likely pay higher premiums. Furthermore, you’re likely to earn less interest on whole life insurance than other kinds of investments.
4. What are the 4 types of insurance?
Different kinds of general insurance include motor insurance, health insurance, travel insurance, and home insurance.
5. What are liabilities in insurance?
Liability insurance gives protection against claims resulting from injuries and damage to people and/or property.
6. What is the advantage of insurance?
The obvious and most significant advantage of insurance is the payment of losses. An insurance policy is a contract utilized to indemnify individuals and organizations for covered losses. The second advantage of insurance is managing cash flow uncertainty. Insurance gives you to pay for covered losses when they happen.
7. What are the kinds of insurance?
• Life Insurance.
• Motor insurance.
• Health insurance.
• Travel insurance.
• Property insurance.
• Mobile insurance.
• Cycle insurance.
• Bite-size insurance.
8. What does health insurance cost in USA?
The average annual cost of health insurance in the USA is $7,470 for an individual and $21,342 for a family as of July 2020, according to the Kaiser Family Foundation – a bill employers typically fund roughly three quarters of.
9. Is it worth to buy health insurance?
The benefits of health insurance cannot be overstated. Having a health insurance policy can help you get medical care without blowing up all your money.
