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For most people, the world of health insurance is confusing and overwhelming. There’s a lot to learn, and most people end up doing it on the fly while they’re trying to get much-needed care. To better prepare yourself for potential conversations with your insurance agency, here are several terms you should know.

5 Common Health Insurance Terms

1. Deductible

Your deductible is the amount of money you must pay in a plan year before your insurance starts covering various services. This can get confusing, as insurance companies often cover certain services—like preventive care—before you’ve met your deductible. Your deductible can range from $1,000 to much higher if you have a high deductible health plan.

2. Premium

The premium is what you pay monthly for your insurance coverage. In general, the higher your deductible, the lower your monthly premium. High deductible health plans, for instance, feature much lower premiums, but won’t cover certain care or procedures until these premiums have been met.

3. Copays

Copayments, often referred to as “copays”, are the fees you pay for certain healthcare services. Your copay generally varies based on the type of care you’re receiving. The copay for your primary care physician will typically be much lower than the copay to see a specialist or for emergency care. These usually won’t count toward your deductible.

4. Coinsurance

After you meet your deductible, you may still have to pay for any medical care you receive. Typically, this is a percentage of the bill known as coinsurance. Many health insurance plans feature an 80/20 coinsurance, meaning your insurance company covers 80% of a particular bill and you’re responsible for the other 20%.

health insurance5. Health Savings Account

A health savings account, or HSA, gives you the option to allocate up to $3,350 for medical expenses pre-tax. You can then use these funds to pay for any medical services or care, and you aren’t taxed for making withdrawals. Funds in an HSA can roll over from one plan year to the next, unlike a flexible savings account (FSA), which requires individuals to use all the funds before the year ends.

 

If you still don’t feel confident navigating your way around the world of health insurance, you’re not alone. Fortunately, for those in the Greater Cincinnati, Northern Kentucky, and Southeast Indiana areas, Siemers Insurance Agency is here to help. As an independent insurance agency, they offer a range of products and policies and can help you find one to suit your and your family’s needs. To request an insurance quote, call (513) 469-8877 or go online.

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