Choosing a health insurance plan is an important decision. Like with any big purchase, you’ll want to compare how much you pay and what you’ll get in return.
When you’re shopping for a plan, the “price tag” is the monthly premium, which is the amount you pay to your health insurance company to keep your coverage active. But that is only the cost to buy the health plan — what does is it cost to actually use your benefits?
There are several more things to consider beyond the premium:
- Whether the doctors and hospitals you use are in the network
- What services and prescription drugs are covered (or not covered)
- How much your health insurance company pays for covered services you receive
- How much you’re responsible to pay out of your own pocket for things like doctor visits, prescription drugs, or hospital stays
- Whether your health plan has a deductible, how high it is, and which services it applies to
How to Find the Best Health Plan for Your Budget
With all these factors to consider, how can you decide which health plan works best for you? To get started, it’s important to make sure you’re familiar with these common cost-related health insurance terms:
- Cost-sharing – Cost-sharing refers to the amount of money you pay out-of-pocket for health care services that aren’t fully (100 percent) covered by your health insurance company. Cost-sharing includes types of payments called copayments, coinsurance, and deductibles.
- Copayment – The copayment (or copay) is the set amount you pay for a covered health care service. Your copay is typically due when you receive the health care service and varies by service. For example, the copay for seeing your primary care physician is different from your copay for an emergency room visit.
- Coinsurance – Coinsurance is the percentage you pay out-of-pocket for some covered health care services. For example, if your coinsurance for radiology services is 20 percent, your health insurance company pays 80 percent of the cost and you pay the remaining 20 percent.
- Deductible – Your deductible refers to the amount of money you pay out-of-pocket for health care services before your health insurance company starts paying some or all of the costs. Deductibles may only apply to certain health care services and are outlined in your health plan’s Summary of Benefits.
As you’re shopping, you’ll find this information in the Summary of Benefits, a detailed chart that shows all the services the health plan covers and how much it would cost you for each type of service.
Does A Higher Premium Mean I Pay Less Out-of-Pocket?
The simple answer: Sometimes.
Be sure to look at what out-of-pockets costs you’ll pay when you receive services. You’ll also want to think about how much you anticipate using heath care services. If you expect to use them frequently in the plan year, you may want to pick a plan with a higher premium so you can pay less for each service. But if you expect to have a year of good health, it may be more affordable to choose a lower-premium option.
Independence offers the most plan options
Independence is proud to have served the Philadelphia region for more than 80 years. And we’re the only health insurance carrier in the area to continuously offer coverage on the Health Insurance Marketplace since the Affordable Care Act started in 2013
Our 2021 health plans offer you the widest selection, including health plans with no deductible. We can help you find the best plan for your personal health, budget, and preferences.
No matter which Independence Blue Cross health plan you choose, you always have:
- Access to the entire provider network — never a limited network
- An Accolade Health Assistant, who is your single point of contact to make your health care experience easier
You also get 24/7 access to:
- A licensed, board-certified doctor by phone or video chat through telemedicine
- A Registered Nurse who can answer your health-related questions and help you make informed decisions about your care
Learn more about choosing the right health plan.