Choosing a health insurance plan
is an important decision. Like you would with other big purchases, be sure
to compare how much you will pay and the value of what you’ll get in return.
When you’re shopping for a health plan, the “price tag” you see is the
monthly premium. This is the amount you will pay to your health insurance
company to keep your coverage active. But that is only the cost to
buy
the health plan. What will it cost you when you use your
benefits, and will you have access to high-quality care?
Here are other factors to consider in addition to the monthly premium:
• Are your favorite doctors and hospitals in the network?
• What services and prescription drugs are covered (or not covered)?
• How much will your health insurance company pay when you receive covered
services?• How much are you responsible to pay out of your own pocket for things like
doctor visits,
prescription drugs, and hospital stays?• Does your health plan have a deductible, how high it is, and which services
does it apply 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 become 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. Cost-sharing may include
copayments, coinsurance, and deductibles.• Copayment– A copayment (or copay) is a set amount you pay
for a covered health care service. Your copay is typically due when you
receive the health care service, and the amount will be different for
different services. For example, the copay for seeing your primary care
physician may be 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%, your health insurance company
pays 80% of the cost, and you pay the remaining 20%.• Deductible
– A deductible is 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. Every health plan has different deductibles, and a deductible may
only apply to some services and not others.
As you’re shopping, refer to the Summary of Benefits for each health plan to
see what cost-sharing applies. The Summary of Benefits is a detailed chart
that shows all the services the health plan covers and your out-of-pocket
costs for each service.
Does a Higher Premium Mean I Pay Less Out-of-Pocket?
The simple answer: Usually.
Be sure to look at what out-of-pocket costs you’ll pay when you receive
services. You’ll also want to think about how much you anticipate using your
benefits. If you expect to use health care services 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 are not someone who uses health care services
often, it may be more affordable to choose a lower-premium plan.
IBX Offers the Most Plan Options
With the largest network of doctors and hospitals in the region, no other
health insurance company knows Philly like Independence Blue Cross (IBX).
And we’re the only health insurance carrier in the area that has
continuously offered coverage for individuals and families since the start
of the Affordable Care Act.
- MORE ON HEALTH INSURANCE:
- Does Medicare cover mental health therapy?
- How to enroll in an Independence Blue Cross health insurance plan
- Finding a primary care doctor
Our 2025 options include
health plans with no deductible. IBX offers the widest selection so you can find an
affordable health plan
that works for your personal health, budget, and preferences. If you need
help finding the right health plan, IBX is here for you! Call 1‑888‑475‑6206
(TTY: 711) to speak to a licensed agent.
With comprehensive coverage like ours, you have access to the care and
support you need.
Learn more about
choosing the right health plan.
This content was originally published on
IBX Insights.
