Health

Health Insurance

Health insurance is insurance against the risk of incurring medical expenses. Health insurance helps pay your medical bills when you seek medical care.

According to the Health Insurance Association of America, health insurance is defined as "coverage that provides for the payments of benefits as a result of sickness or injury.

An insured person’s obligations may take several forms:

Premium: The amount the policy-holder pays to the health plan.
Deductible: The amount that the insured must pay out-of-pocket before the health insurer pays its share. For example, policy-holders might have to pay a $1000 deductible per year, before any of their health care expenses are covered by the health insurer.
Co-payment: The amount that the insured person must pay out of pocket before the health insurer pays for a particular visit or service. For example, an insured person might pay a $25 co-payment for a doctor's visit, or to obtain a prescription.
Coinsurance Instead of, or in addition to, paying a fixed amount up front (a co-payment), the co-insurance is a percentage of the total cost that an insured person may also pay. For example, the insured might have to pay 20% of the cost of a surgery over and above a co-payment, while the insurance company pays the remaining 80%. If there is an upper limit on coinsurance, the policy-holder could end up owing very little, or a great deal, depending on the actual costs of the services they obtain.
Out-of-pocket maximum: Similar to coverage limits, except that in this case, the insured person's payment obligation ends when they reach the out-of-pocket maximum, and health insurance pays all further covered costs.

True cost for Health Insurance usually equals the Premium + the out-of-pocket Maximum.

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To learn more about Health Insurance, contact us at
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