If you feel lost when faced with insurance terminology or could benefit from an overview of the most critical components of an individual health insurance plan, rest assured you’re not alone. Understanding the cost and coverage details as they pertain to health insurance can help you make an informed decision when it comes time to select a plan.
Let’s First Brush Up on Some Terminology
All of these terms describe costs you can expect to pay in a given year for individual health insurance. It’s crucial to be familiar with the specifics of your health insurance coverage, that way you aren’t caught off guard by out-of-pocket costs or other unexpected expenses throughout the course of a year.
- Premium – el pago mensual que usted envía a su compañía de seguros.
- Deductible – the set amount you’re responsible for paying until the insurer begins to pay their share. For example, if you have a $1,000 deductible, you must pay that in full before your provider will start to pay.
- Copayment (Copay) – the fixed amount you pay each time you have a prescription filled or visit the doctor’s office. Not all insurance plans have copayments, and the ones that do typically don’t count toward the deductible.
- Coinsurance – just as the prefix “co-“ implies, this is a cost shared between you and your insurance provider. Not all plans include coinsurance, so make sure to check on this when comparing and contrasting various options.
- Out-of-Pocket Maximum – el máximo absoluto que se le solicitará que pague por todos y cada uno de los gastos médicos en un año determinado (después de cumplir con su deducible, coseguro, etc.) antes de que su aseguradora intervenga y asuma la responsabilidad de los gastos médicos en los que incurra durante el resto del año.
Cómo determinar qué tipo de cobertura es mejor para usted
While you can’t foresee the unexpected, such as freak accidents or illnesses/conditions that arise out of the blue, if everything goes according to plan you can generally come up with a rough estimate as to how much care you’re going to need in a given year. Having this estimate in mind when evaluating health insurance plans should help you select the one that will best fit your budget and coverage needs.
Si usted Don’t Anticipate Having to Use A Lot of Care During the Upcoming Year …
A plan with a lower monthly premium and higher deductible may provide the best of both worlds. While you’ll face higher costs when you do receive care, you’ll benefit from significantly lower payments each month. As long as you don’t need to frequently visit the doctor or require monthly prescriptions, this may be the best option for you.
Para ilustrar cuánto podría ahorrar con un plan de prima baja y deducible alto, considere que en 2015 el individuo promedio con este tipo de plan ahorró $1,4 billones de dólares solo en costos de prima mensual.
Si usted Hacer Anticipate Having to Visit the Doctor on a Regular Basis …
A plan with a higher monthly premium and lower deductible may better fit your needs. Although you’ll pay more each month, if you go to the doctor frequently you’ll benefit from lower copays, coinsurance, deductibles and out-of-pocket limits, which should save you money in the long run (so long as you’re truly receiving care on a regular basis, otherwise it may end up costing more).
Why It’s So Imperative to Have Adequate Health Insurance Coverage
Nobody plans or has the ability to foresee themselves getting sick or hurt, but over the years odds are you’re going to need some type of medical care. Without individual health insurance, you run the risk of facing incredibly high costs for medical services and also miss out on the array of benefits that go along with being covered.
To learn more about the numerous benefits of having adequate health coverage or to speak with a specialist about which plan will best meet your cost and coverage needs, contact us today. We’ll be happy to provide you with a cotización de seguro de salud gratuita ¡De todos nuestros transportistas a la vez!
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