As Open Enrollment kicks off next month, we want to make sure you feel confident and informed as you seek out the health insurance plan that works best for you.
Be sure to compare health insurance plans to find the best value and suitable for your needs. Here are some basic terms to know:
- Premium: This is the amount you’ll pay monthly to keep your plan active.
- Covered services: These are the health care services that your insurance plan will help you pay for. This can change based on the plan, but usually, plans with a higher monthly premium will cover more of the cost of your care.
- Copayments: Often shortened to copays, this is the cost that you’re responsible for paying for a covered appointment, service, or prescription. For instance, if you have a $10 copay for a visit to a doctor, you will pay a maximum of $10, and your insurer will pay the rest, regardless of the actual total cost.
- Coinsurance: This is similar to a copayment, but instead of being a fixed cost ($10), it’s a fixed percentage of the total cost of the appointment, service, or prescription. So if you see a specialist that requires a 20% coinsurance and the total cost of that appointment is $100, you’ll owe $20, and your insurer will pay the remaining $80.
- Deductible: If your insurance plan has a deductible, this is the total cost that you’ll need to pay out-of-pocket before your insurer begins paying for services. Once you hit that number, you’ll only owe copays, coinsurance, or maybe nothing at all. Related to this is the out-of-pocket max, the maximum amount of money that you would ever be expected to pay in a single calendar year. Once you hit that—through copays, coinsurance, or payments towards your deductible—you should owe nothing again beyond your monthly premium.
Are you someone who is generally healthy and sees a doctor only a few times per year? If so, you might be an excellent fit for a low-premium, high-deductible plan, where you’ll pay a lower monthly rate but would pay more out-of-pocket in an emergency or for any unexpected health needs.
If you have an existing health issue or if you tend to see specialists regularly, it might make sense to pay a higher monthly premium but have fewer out-of-pocket expenses because doctor visits and diagnostic tests are more likely to be covered by your insurer.
Call Cosmo Insurance Agency at 732-363-3888, or visit our website for a free quote.
Cosmo Insurance Agency is a full-service independent insurance agency based in Hackensack (Bergen County) and Lakewood (Ocean County), New Jersey that offers an all-encompassing range of insurance options for both individuals and businesses. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating our knowledge of the insurance guidelines for healthcare, employee benefits, life insurance, self-insurance, dental, disability, and long term care insurance, we keep our clients up-to-date with affordable plans that cover all their specific insurance needs.
