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Important Health Insurance Terms You’ll need to know these terms in order to understand the details of potential coverage. Premium: The amount per month you pay for your health insurance. Benefits: The services your healthcare provider agrees to cover. Examples of common benefits include preventative care, sick doctor visits, prescriptions, and medical equipment. Copay: The flat fee you pay when you go to a medical facility under certain plans.

Coinsurance: Unlike copayments, which require you to pay an agreed upon flat fee, coinsurance requires you to share a percentage of your medical costs with your insurer. 30, meaning your insurance carrier will pay for 80 or 70 percent of services, and you’ll pay the rest. Coinsurance payments are sometimes associated with out of network services, many of which will end up being specialized, costly treatments. Deductible: This is the amount of money you must pay before your insurance provides coverage. 1500, you have to pay that amount in health costs before the insurer contributes. Not all plans have a deductible, however, and not all services are subject to the deductible.

Going in for preventative care or a sick visit, for example, usually requires a copay or coinsurance payment but does not count toward your deductible amount. Out-of-Pocket Limit: Even after meeting your deductible, you may still be responsible for copayments and coinsurance up to your out-of-pocket limit. This means the absolute total you’ll have to pay in a year. After this point, insurance covers all costs. A plan that both provides healthcare coverage and services, HMOs will often require you to exclusively see providers and hospitals listed as part of the HMO’s network. You’ll get comprehensive benefits within the network but less flexibility if you go outside of the network.

This is more flexible than an HMO plan. You’ll be covered for in-network care and may be partially covered for out-of-network care. You can see that when comparing plans, your age, income and zip are immediately taken into account. Customizable fields allow you to filter your options by premiums, deductibles, out-of-pocket expenses, providers and network types, to name just a few. The programs listed allow you to look at consumer and industry quality ratings, your estimated premiums and all other associated costs. Finally, you can choose to compare a number of programs side by side.

Trying to understand the jargon and get the most for your dollar can be overwhelming, especially with all the recent changes to health insurance. Know the financial strength of your potential insurer. Look up its rating on A. Best, Standard and Poor’s, or another credit rating company.

Carefully read the benefits covered and excluded in a policy you’re considering. You’ll also want to spot the policy’s deductible, copays, and out-of-pocket maximum. Make a reasonable estimate of your healthcare costs per year, based on the policy’s provisions. Realize that you may not have all the benefits you had before under your parents’ or employer’s policy. Assess what you really need in terms of care before assuming you should take a policy identical to your previous one.

Check the insurance company’s policy about dropping care to make sure you won’t be fined if you have to drop coverage because you get a job with health benefits. Do your research: don’t assume that a quote from one insurance company is what you have to pay. Health Insurance section will help you further understand the intricacies of a policy and what you should be paying. You’ll also want to think about whether you’re likely to be traveling. In addition to the pointers above, if you’re buying a health care policy for the first time and plan to visit or live overseas, you’ll need to make sure you find coverage that doesn’t leave you stranded. Getting the Most for Your Money With so many different healthcare policies to choose from, it’s tough to know when you’ve found the perfect combination of coverage and economy. Don’t buy a plan just because it has the lowest monthly premium or smallest deductible: What you save on the premium can easily be made up in copays and the out-of-pocket maximum.

Tally your healthcare spending from last year and estimate how much you’d spend under the policy you’re considering. Some insurance agencies provide an online calculator. Consider skipping prescription coverage: This is not wise if you already need medications or are middle-aged or older, but for young people in good health, this can help cut costs. Check out the new health insurance marketplace: This does allow you to compare and contrast premium prices and plan benefits, which is to your advantage. Setup an HSA, or Health Savings Account, especially if you have high healthcare costs: This allows you to contribute a portion of your monthly paycheck to a Health Savings Account.

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