Frequently Asked Questions for Health Insurance

What is a premium?

A premium is the monthly cost of keeping your insurance policy in effect. Health Insurance premiums are determined by a variety of factors, including your medical history, your age and your gender.

What is a deductible?

A deductible is an amount of medical expenses you are responsible for paying before your insurance starts covering you. A common deductible is $1500 – this means you would be responsible for paying the first $1500 in medical bills before your carrier begins to pay on your behalf. Having a higher deductible usually means you enjoy lower monthly premiums.

What is a co-payment?

A co-payment is a fixed dollar amount that you are responsible for paying for a particular medical service. For example, many insurance plans have $25 co-payments for doctor visits. This means it will cost you $25 to see a doctor. Some office visit co-payments cover labs and x-rays done in office also, be sure to ask your doctor.

What is coinsurance?

Coinsurance is an amount of the cost of a medical service that you are responsible for paying. Unlike a co-payment, which is a fixed-dollar amount, coinsurance is expressed as a percentage. For example, many insurance plans have 20% coinsurance for hospital costs - meaning you pay 20% of the total cost of a trip to the hospital after deductible.

What's an out-of-pocket expense?

An out-of-pocket expense is any cost you have to pay yourself when receiving medical care. This includes your deductible, co-payments, and coinsurance. Most health insurance policies have an annual maximum out-of-pocket expense. Once you’ve paid out enough money to meet that maximum, your insurance company will pay the rest of your medical costs. This is also referred to as your out-of-pocket maximum.

What is a Health Savings Account?

Health Savings Accounts aren't health insurance plans. Instead, they are a financial tool designed to help make your healthcare more affordable. The money you deposit in an HSA is tax-free. You don't pay taxes on qualified withdrawals, either. In effect, it's like getting extra money from the government to pay for healthcare. To open an HSA, you first have to purchase an eligible high deductible health plan.

Why should I buy health insurance?

Having health insurance isn't just about paying medical bills. It's about knowing that you'll always have access to quality care. Health insurance makes seeing the doctor easy and affordable - and that means you're more likely to stay healthy.

How can I explore my health insurance options?

The best way to explore your health insurance options is to get the advice of a professional Agent.

Please remember that all individual plans are underwritten and subject to pre-existing conditions (unless you are under the age of 19). To learn more about which options are right for you, contact us – we are always happy to answer any questions.