Among all kinds of insurance plans, health insurance is a must for you and your family. When you don’t have protection against exorbitant healthcare expenses, it can lead to immense stress and anxiety. Therefore, it makes sense to buy a health insurance plan timely. However, with so many jargons, it can be difficult for you to determine the right healthcare plan for you. While working with a health insurance broker in Austin is the best way to find the best health insurance, this guide will make it easier for you to understand the common terms that you might find confusing.
Terms to Understand Before You Buy Health Insurance
Knowing the following terms before open enrollment will be helpful for you to better understand a health insurance policy.
Premiums: It is the amount of money you will need to pay regularly to maintain your health insurance. You might be offered the option to pay premiums monthly or annually. It is essential to remember that higher premiums usually lead to lower deductibles.
Deductibles: It is the amount of money you need to pay upfront until your health insurance policy comes in effect. For instance, with a $3,500 deductible, you will pay the first $3,500 of covered services yourself. Once you have covered your medical expenses worth this amount, your insurer will be liable to pay the rest of the claim amount.
Co-insurance: The co-insurance is typically a fixed percentage that you will pay after you have met your deductible. The rest of the claim amount is paid by your health insurance provider. For instance, your coinsurance is 25% for a visit to the doctor that costs $100. Once you have paid your deductible in full, you will need to pay only $25 and the rest amount will be paid by your insurance provider.
Co-payment: Also called copay, it is the fixed amount you have to pay at the time of service (after you have paid your deductible). Let’s assume you are going to visit your family doctor for a checkup that costs $100. If the standard copay is $20, you will pay only $20 at the time of visit and your insurance company will pay the rest.
Other Important Things You Must Know
Some health insurance plans may need you to get a referral to see a specialist. Meaning, if you want to see a heart specialist, first, you will need to see a general physician who will refer you to a heart specialist after evaluation. However, not all plans have this requirement. Besides, most health insurance plans have a network of doctors and to avail of the benefit of such plans, you need to visit a doctor from that network only. Otherwise, you will need to pay the entire cost out of your pocket.
Do you have other health care terms that confuse you? A health insurance broker in Austin can assist you with anything you need to know about health insurance plans and the terms used in them.