One of the first questions many people ask about health insurance is “How much will this cost me?” The answer to this question is different for everyone, but there are certain costs that you can expect to pay.

What will you pay for health insurance?

The amount you pay for health insurance each month is called a premium. The amount you pay depends on the coverage you receive, the number of people covered and your plan’s deductible. Plan rates also vary based on your age, where you live and if you use tobacco. As long as you make your monthly payment, your insurance will remain active. 

What is a deductible?

A health insurance deductible is the amount of money you must pay before your plan starts to help you pay your bills. If your plan has a $1,000 deductible, you must pay that much toward medical care before your insurance company begins paying for some of your costs. 

Are there other costs I have to pay?

During the year, you will be asked to pay for some things yourself. Here’s a rundown of some costs you may have to pay. 

Copayments  A payment you make at the doctor’s office, urgent care clinic, ER or the pharmacy
Example: $25 copayment at the doctor’s office
Coinsurance     Your percentage of medical bills left after your provider pays their share
Example: 20 percent coinsurance for a hospital stay
Out-of-network or uncovered treatment If you go to a doctor who’s not in the plan network or if the type of treatment is not covered by the plan, you may have to pay a higher percentage of the costs (or the full cost of care)

There are limits to how much you spend

Recent laws put a cap on the amount of money you are expected to pay out of pocket each year. It’s called an out-of-pocket limit or out-of-pocket max. Once you have reached this amount, your insurance provider must pay all of your covered costs for the rest of the year. 

Choosing the right plan to keep costs low 

Keeping your health insurance costs low is important for your budget. It is also important to choose a plan that offers the coverage you actually need. 

When choosing a plan, think about:

  • How often you see your doctor
  • How many medications you take
  • How much you are willing to pay yourself
  • What you can afford for a monthly payment
  • Whether you smoke or use tobacco
  • What insurance your doctor accepts
  • Any medical conditions you may already have
  • Any special programs or subsidies you may be able to receive

By keeping these things in mind, you can choose the plan that fits your needs and budget. Learn more about how to choose a health plan.

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