Health insurance is a way to help pay for health care expenses. Like car insurance or home insurance, you can choose from a variety of plans to meet your budget and health care needs.
How insurance works
No matter which health insurance plan you choose, you’ll pay a monthly payment (your premium ) to keep your health insurance coverage. You may also pay each time you receive medical care (co-payment or co-insurance ). Generally, the higher your premium, the lower your deductibles and out-of-pocket costs – and vice versa.
Health insurance plans vary in what services are covered and the amount the insurance company will pay. The term cost-sharing is often used to describe the share of costs covered by your insurance that you pay out of your own pocket. This generally includes deductibles , co-insurance , and co-payments , but it doesn't include premiums , balance billing amounts for non-network providers, or the cost of non-covered services. When the amount you pay reaches the out-of-pocket maximum, the insurance company pays for all covered services.
Why get health insurance?
Nobody plans to have an accident or get sick.
You never know when you’ll need care and the costs of care can be very high. Your health insurance may pay some of your medical costs.
It helps you stay healthy.
Recommended preventive care services are covered at 100% in our Marketplace plans, helping you to avoid health issues, or detect them earlier. Most plans include wellness tools and programs, too.
You may get a tax credit to help pay your monthly insurance premium.
In 2014, Marketplace applicants saved an average of $263 a month* with a tax credit.
You have to have it.
Under the health reform law, almost everyone needs to have health insurance or pay a penalty.**
Ways to Save Money
We're working to make it simpler for you to shop, and to save money on your health insurance and health care. Here are a few ways you may save:
Tax credit (subsidy)
If you don’t have health insurance through your employer, you may be able to get a tax credit (also called a subsidy) that helps you pay for a health insurance plan offered in the Marketplace. Look at the chart below to see if you may qualify based on your family size and income.
Government-sponsored health coverage
You or your family may qualify for no cost or low cost government-sponsored coverage through Medicare, Medicaid or the Children's Health Insurance Program (CHIP).
Cost sharing reduction
This discount lowers the amount you pay out-of-pocket for deductibles, coinsurance, and copayments. You can get this reduction if your income is below a certain level, and you choose a Marketplace health plan from the Silver plan category. If you're a member of a federally recognized tribe, you may qualify for additional cost-sharing benefits.
Save on health care services
Use a network doctor, clinic or hospital – Before you visit a health care provider, check to see if they are in the plan network. We negotiate discounts with network providers to help you save money. If you see a provider that's not in the network, it may cost much more. To find doctors, clinics and hospitals in the network for Marketplace health plans, check the provider directory.
See how much a medical procedure costs – Use the cost estimator on myuhc.com to see how much your care may cost. Compare the costs for different providers and use that information to plan and budget for care.
Know when to seek emergency care – It's usually best to visit your primary care doctor or an urgent care center, unless it is an emergency.
Save on prescription drugs – Talk with your doctor about generic drugs which usually cost less. You may also save money when you order prescriptions by mail. To see if your medications are covered in the Marketplace health plans, check the Prescription Drug List for commonly prescribed medications that are covered.*
Consider a Health Savings Account – A health insurance plan with a health savings account (HSA) allows you to put away a limited amount of pre-tax dollars to pay for eligible medical expenses.
Check the plan network
All plans cover visits to network doctors, clinics and hospitals. No matter which plan you choose, you'll always save money when you see a network provider. To find doctors, clinics and hospitals in the network for Marketplace health plans, check the provider directory.
Decide which level of coverage you need
Health insurance plans are organized into 4 metallic levels, based on how you and the plan will share costs. The plans in all 4 categories offer the same essential health benefits. The difference is in how much help you want paying for things like hospital visits or prescription medications. For example, bronze plans may have lower premium costs, but you may pay more for health services.
Each health insurance plan has a Prescription Drug List of covered medications. The drugs are grouped into cost levels, called tiers. The drug tier indicates the amount you pay for a prescription, as determined by your benefit plan. You’ll save money by using medications in tier one (lowest cost). To see if your medications are covered in the Marketplace health plans, check the Prescription Drug List for commonly prescribed medications that are covered.*
Exclusions and limitations
Make sure you're aware of what might not be covered. Common exclusions and limitations include elective or cosmetic surgery and alternative therapies. While some plans cover pediatric dental and vision services, dental and vision plans for adults may need to be purchased as they are separate plans.
Insurance Plan Categories
There are four levels of health insurance plans available on the Marketplace: bronze, silver, gold and platinum. As you compare plans, you'll want to think about how often you visit the doctor and how much you’ll pay for monthly premium, deductible, co-pays and co-insurance amounts.
No comments:
Post a Comment