Frequently Asked Questions
What is a premium in health insurance?
A premium is the amount you pay for your health insurance every month. It's a recurring cost that keeps your coverage active, regardless of whether you use any health services during that time.
How does a deductible work?
A deductible is the amount you must pay out-of-pocket for healthcare services before your health insurance begins to pay. For example, if your deductible is $1,000, you'll need to spend that much on covered services before your insurer starts covering a portion of the costs.
What are copayments and coinsurance?
Copayments, or copays, are fixed amounts you pay for specific healthcare services, like doctor visits or prescriptions, after you've met your deductible. Coinsurance is the percentage of costs you share with your insurance company after meeting your deductible. For example, if your coinsurance is 20%, you pay 20% of the cost of the service, and your insurer pays the remaining 80%.
What is the difference between an HMO and a PPO?
An HMO (Health Maintenance Organization) requires members to use a network of doctors and hospitals, and typically requires referrals to see specialists. A PPO (Preferred Provider Organization) offers more flexibility by allowing members to see any healthcare provider, but using in-network providers will cost less.
Why is network choice important in health insurance?
Network choice is important because it affects which doctors and hospitals you can use and how much you will pay. In-network providers generally cost less, as insurance companies negotiate lower rates with them. Using out-of-network providers can result in higher out-of-pocket costs.