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The Basics of Shopping for a Health Insurance Plan

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If you’ve decided to take advantage of the Open Enrollment period to enroll in a health insurance plan, or if you’re simply reviewing your current plan and your family.

Your premium is the amount that you pay each month for health insurance coverage. Premiums are completely separate from co-pays and deductibles. Many Californians receive subsidies to help with the cost of their premiums.

The deductible is the amount that you will pay toward your medical bills, each year, before your health insurance kicks in to cover the rest. For example, if your health insurance plan has a $2,000 deductible, you will pay the first $2,000 of your medical bills each year. Then your health insurance will cover your bills, to the extent stated under the policy (there are some exceptions).

Your health insurance might cover routine preventive care, even if you haven’t reached your deductible. But you might be charged a co-pay for these visits to your physician. Usually, co-pays are around 20 to 30 dollars per visit, but can vary according to your plan.

Remember, when you compare plans, to look closely at the differences between deductibles, premiums, and co-pays. Otherwise, your out-of-pocket expenses could add up very differently than you had imagined.

Health insurance plans are packaged into four “tiers”: Bronze, Silver, Gold, and co-pays, but also charge lower monthly premiums.

Health insurance plans are separated according to network type: PPO, HMO, and EPO. Depending upon your network type, you might receive coverage only from certain providers, clinics, or hospitals. Or, you might be able to choose your provider. Make sure to ask detailed questions about each plan’s network type, or else you might end up unhappy with your provider options.

Shopping for health insurance plans can be overwhelming. Remember that we offer free help, and give us a call!