Making insurance tailored to me

There are a few things to consider when deciding on a health plan, including monthly costs and how often you will visit the doctor. An enrollment assister can help you choose the right plan for you and your family.

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PREMIUMS

Premiums are monthly, quarterly, or yearly costs that you pay to have insurance regardless of whether you use services.

PREMIUMS

Each health plan will be different based on how much you pay for your health insurance plan either every month, every three months, or every year. These costs are called premiums. You will need to pay the premium to keep your insurance active. You will need to pay the premium even if you do not visit the doctor or hospital.

ADDITIONAL COSTS (OUT-OF-POCKET-COSTS)

Each health plan will have different levels of additional costs, which you will pay whenever you see the doctor. These additional costs are called out-of-pocket costs.

ADDITIONAL COSTS (OUT-OF-POCKET-COSTS)

You will need to pay out-of-pocket-costs in addition to your premium, even if your health insurance plan covers these services. These out-of-pocket costs include deductibles, co-insurance, and co-payments.   Insurance plans will either have co-insurance or co-payments not both.

  • Deductibles: This is the amount you owe for seeing the doctor or using any kind of care before your health insurance plan begins to pay. For example, if your deductible is $1,000, your plan will not pay anything until you’ve paid $1,000 for covered services.
  • Co-insurance: This is the percentage of costs you pay for seeing the doctor once you have paid the deductible. For example, if visiting the doctor costs $100 and you have met your deductible, your 20% coinsurance payment would be $20. The health insurance plan pays the rest.
  • Co-payment: This is a fixed amount you pay for seeing the doctor. For example, if your co-payment is $15, then you will pay $15 every time you see the doctor.

HOW OFTEN YOU PLAN ON VISITING YOUR DOCTOR

Different health insurance
plans cover different services.

HOW OFTEN YOU PLAN ON VISITING YOUR DOCTOR

To learn more about preventive services, visit healthcare.gov

If you think that you will visit the doctor or hospital often, you may want to have a health plan that covers more health care services through the premium and requires you to make smaller payments out-of-pocket.

Even if you are happy with your current health plan, it is important for you to review your health plan every year. If you have a qualified major life change, such as marriage, having a child, or losing your health insurance, you may qualify for a Special Enrollment Period.