Things to Know

5 Things To Know About Health Insurance

1. Know What Your Insurance Offers

There are many kinds of private health insurance policies. Different kinds of policies can offer very different kinds of benefits, and some can limit which doctors, hospitals, or other providers you can use.

2. Is There a Co-Pay?

You may have to pay coinsurance or a copayment as your share of the cost when you get a medical service, like a doctor’s visit, hospital outpatient visit, or a prescription. Coinsurance is usually a percentage amount (for example, 20% of the total cost). A copayment is usually a set dollar amount (for example, you might pay $10 or $20 for a prescription or doctor’s visit).

3. What is Your Deductible?

You may have to pay a deductible each plan year before your insurance starts to pay for care you get. For example, let’s say you have a $200 deductible. You go to the emergency room and the total cost is $1250. You pay the first $200 to cover the deductible, and then your insurance starts to pay its share.

4. Does Your Provider Work With a Specific Network Only?

Health insurance plans contract with networks of hospitals, doctors, pharmacies, and health care providers to take care of people in the plan. Depending on the type of policy you buy, your plan may only pay for your care when you get it from a provider in the plan’s network, or you may have to pay a bigger share of the bill.

5. Are You Getting Full Coverage For Your Insurance? Or Partial?

You may see products that look and sound like health insurance, but don’t give you the same protection as full health insurance. Some examples are policies that only cover certain diseases, policies that only cover you if you’re hurt in an accident, or plans that offer you discounts on health services. Don’t mistake insurance-like products for full comprehensive insurance protection.