Marketplace Insurance Assistance
UNDERSTANDING HEALTH INSURANCE AND PLAN CHOICES IN THE MARKETPLACE
Health insurance helps you pay for medical care and can protect you from high health care costs, like emergency room visits or hospital stays after a car accident. These health care bills can add up quickly and often cause people to go into debt or even bankruptcy. There are important things to look at when Buying health insurance:
• The health services the plan covers.
• How much you’ll pay for the plan – monthly premiums.
• How much you’ll pay for things like doctor visits or prescription medicine – cost--‐sharing.
How does health insurance work?
Health insurance helps pay for the cost of medical care by reducing the amount you personally pay when you have medical needs. The amount you pay depends on your specific health insurance plan. Most health plans use a combination of the following:
• Premiums – A premium is a set amount you pay for your health insurance plan, usually paid every month. You pay your premium even if you don't receive medical care that month.
• Deductibles – A deductible is the amount of money you pay for health care services before your insurance plan begins to pay for covered health services. For example, if your health insurance plan has a $1,000 deductible, you must pay $1,000 for medical care before your insurance will start paying. A deductible may not apply to all health services, such as preventive care.
• Co--‐pay – A co-payment, also called a co-pay, is a fixed amount you’ll pay for medical services. For example, you may pay $25 every time you visit your doctor. Your health plan will pay the rest of the cost for that visit.
• Coinsurance – Coinsurance is where you pay a percentage of the cost for a covered health service. For example, if your health insurance plan’s allowed amount for an office visit is $100 and your coinsurance is 20%, you’d pay $20. Your health insurance plan pays the rest. The coinsurance percentage depends on your specific insurance plan.
Certified Application Counselor