Cost of Health Insurance
Below is a short overview of each of these costs:
- Deductible – Except for free preventive services, this will be how much you must pay before the insurance company will pay for any covered health services.
- Copayments and Coinsurance – Once you reach your deductible, you will be responsible for making these payments for each service. Typically, copayments are a flat fee, where coinsurance is normally a percentage.
- Out-of-pocket Maximum – This is the maximum you will have to pay for covered services throughout a year. Once you meet this limit, the insurance company will then pay 100% for any further services during the year.
Estimating and Comparing Yearly Total Costs of Health Insurance
Deciding on a plan based on total costs of care means you will need to create an estimate of the medical services you will need over the course of a year. While it is impossible to predict, you can look back over the past couple of years and get a good idea of your yearly spend.
One of the positives of using the marketplace and HealthCare.gov is that it allows you to choose the expected medical usage of each family member as either low, medium, or high. While looking through plans, an estimate of total costs will be shown based on your household’s expected us of healthcare. Monthly premiums and various out-of-pocket costs can also be viewed in the estimate.
Comparing plans in the marketplace is made easier by using the four metal categories including bronze, silver, gold, and platinum. As a general guideline, the categories with larger premiums will pay more of the total costs of healthcare. Likewise, the two with lower premiums (bronze and silver) will make you pay more total costs. For anyone who does not expect to need regular medical services or regular prescriptions then the bronze plan may be the best option. These plans have low monthly payments, but in return make you pay more of the service costs.
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