How much does health insurance cost?

There are many different factors that go into the cost of health insurance. Before you select a plan, it’s a good idea to look at the healthcare needs of your family and understand your budget. It’s important to understand the out-of-pocket costs that are associated with health insurance plans and pick the one that makes the most sense for you and your family.

Ask these questions

• What prescriptions do you or family members use regularly?
• How important is it to keep your doctors, hospitals and pharmacies?
• Are there upcoming surgeries, procedures or other major healthcare concerns
• How much are you able to spend on healthcare costs?

Insurance terms you should know

There are five insurance terms to know when you look at the overall cost of a health care plan: coinsurance, copay, deductible, premium and maximum out-of-pocket.

• Coinsurance – A percentage of your medical and prescription costs that you pay out of your pocket. For example, if you plan’s coinsurance is 20%, this means you will pay 20% of the cost of your medical or prescription care. Your health insurance plan will pay the other 80%.
• Copay – the fixed dollar amount you pay when you receive medical services or have a prescription filled.
• Deductible – The amount you pay for medical services or prescriptions before your insurance plan pays for your benefits. For example, if your deductible is $1,500, you pay all costs of your medical care until you reach that amount. Your deductible does not apply to most preventive services which are covered at 100% by your insurance.
• Premium – The amount your health insurance plan costs you each month. You pay this even if you do not use any healthcare services.
• Maximum out-of-pocket – the most you could pay toward covered expenses including deductibles, copays and coinsurance. Once you have reached your maximum out-of-pocket, your insurance will pay all covered medical services and prescription costs for the remainder of the year.

Preventive Services

It’s good to know that some medical services are now available to you at no cost, no matter what type of health care plan you choose. Preventive services such as immunizations and screenings are covered when using an in-network provider even if you haven’t met your yearly deductible. Examples of some covered services may include:

• Blood pressure screenings
• Cholesterol screenings
• Colorectal cancer screenings
• Diet counseling
• Depression screenings

What's your budget?

Knowing how much you can afford is a key factor when choosing a plan. Some things to keep in mind when considering your budget for a health care plan:

• Pay more up front – It may be more cost effective for you to pay a higher monthly premium on a plan with a lower deductible. This means your out-of-pocket costs may be higher on a monthly basis, but if the unexpected happens, your insurance will “kick in” more quickly, paying covered medical services sooner. You’ll only have to continue to pay your monthly premium and coinsurance.
• Lower monthly payment – If you don’t anticipate the need for many procedures, services or medications, it might be more economical to select a plan with a lower monthly premium and a higher deductible. Remember that your monthly payment will be lower; but the costs incurred if the unexpected happens will be higher until you reach your deductible. Of course, you will continue to pay your monthly premium and coinsurance.

What if I can't afford health insurance?

Financial assistance is available for many individuals and families to offset the cost of healthcare premiums and out-of-pocket expenses. Depending on your household income and household size, you may qualify for premium tax credits and lower out-of-pocket costs.

To find out if you qualify, talk with a licensed insurance agent, or visit your state exchange or the Health Insurance Marketplace.