When you need health care, you need to know that it will be affordable. Carrying adequate health insurance coverage is the most crucial step to ensure that you and your family will have access to the health care you need.
When you see a doctor, fill a prescription, spend time in the hospital, or employ any other health care service provider, your health insurance coverage will help pay for the service. There are different types of plans that offer different types and levels of coverage.
In most plans, you will have to pay out of pocket for most health care expenses until you’ve reached a certain amount, called the deductible. After paying the deductible, any additional covered health care expenses will be paid primarily by your insurer. There may be a coinsurance or copay charge associated with some or all services, meaning that you will pay a small fraction of the expense while your insurance pays the remainder. Most plans also have an annual out-of-pocket maximum, after which your insurer will pay all covered services, with no coinsurance or copay. As a general rule, plans with higher deductibles will offer lower premiums, and vice versa. Plans are generally classified as “gold,” “silver,” or “bronze,” with gold plans offering the lowest deductibles and bronze plans the lowest premiums.
Most plans will cover some services even before the deductible is met. Such services may include prescription coverage, an annual physical exam, and certain types of preventive care.
Some plans may be associated with a Health Savings Account (HSA), Health Reimbursement Account (HRA), or a Flexible Spending Account (FSA). These are tax-deferred accounts in which you can deposit funds to be used for eligible health care expenses. These plans can help you pay for your health care needs while reducing your tax liability.
Your insurance coverage can make all the difference in guaranteeing you and your family can get the health care you need.