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How does Your Health Insurance Plan Work

 How Your Health Insurance Plan Works

You can no longer buy health insurance Plan without understanding the details of your coverage. When you really think about it are you buying health buying health care insurance or are you buying sickness insurance. Most people don’t really start asking questions about coverage until when they are sick and need medical care. At that time it really does not matter.  You must understand your plan so you can determine the cost of coverage in any year if you have a medical event.

What is the cost of your health insurance?

Your health plan has several things that will affect your monthly premium and the amount you must pay every year. We will attempt to answer the major concerns  about coverage and cost.

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Monthly health Insurance payment

This is the amount you will each month to maintain health care coverage. You will pay this amount usually called premium on the first of each month to keep your health insurance plan active.

Co- Payment

Copayment is a specified amount you pay for coverd health care  service. (Example $20 your share of the cost for primary doctors visits or $ 10 you pay at the pharmacy. These copayment may be different for each health care provider.

Co- Insurance

Your cost of  a covered health care service. This is calculated as a percentage of the allowable service according to your health plan contract (example 20-30% of allowable health care services. In simple terms you pay  a certain % Co-insurance of any allowable medical care after your deductible.


This is the amount yu pay before your health insurance plan pays for any of your health care services. This is your portion of the cost before your health insurance policy pays for any of your care..

Preventive care

Your health Insurance company will pay for one annual doctors visit (Preventive care including labs and other services) for each person on your plan. Preventive care is different for men, women, children and infants. You should communicate clearly to your health care professional for this service. Any visit to your doctor or hospital may be subjected to co-pays, Co-insurance and deductible.

Maximum Out of Pocket

Under the law each policy holder have a maximum out of pocket that you will pay for health care services in any one year. After your out of pocket maximum your health plan pays 100% of all covered cost. See your plan details, Schedule of Benefits.

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