What is Health Insurance Coinsurance? In health insurance, coinsurance is your share of costs of the allowed amount for a covered service after you reach your deductible. Coinsurance is different from a copay which is a fixed dollar amount for services and is not typically dependent on meeting your deductible. How does Coinsurance Work? Each service or drug that is subject… Read More

What is a Health Insurance Copay? In health insurance a copay (copayment) is a fixed amount you pay for covered services, typically when you get the service. Copays differ from coinsurance (the percentage you pay for covered services, usually after reaching your deductible). Each plan treats copays and coinsurance differently, so it’s important to understand if… Read More

What is a Health Insurance Deductible? Your health insurance deductible is the amount you have to pay out-of-pocket for covered services before your insurance begins to pay. It doesn’t include premiums or costs that aren’t covered by your plan. Once you meet your deductible, your plan will pay its share of your coinsurance. TIP: Your maximum deductible… Read More

What is a Health Insurance Premium? Your health insurance premium is the amount paid to an insurer, typically per month, for a health plan. Tax Credits are available to lower monthly premiums through the Health Insurance Marketplace. If you have coverage through work, your employer typically pays part of your premium. Let’s look a little more… Read More

Out-of-Pocket Maximums Under the Affordable Care Act The ACA limits out-of-pocket maximums, the max amount of costs for covered services you’ll pay out-of-pocket in a policy period on your health plan. For 2023, your out-of-pocket maximum can be no more than $9,100 for an individual plan and $18,200 for a family plan before marketplace subsidies…. Read More

What is a Health Savings Account? A Health Savings Account (HSA) is a tax-advantaged medical savings account you can contribute to and draw money from for certain medical expenses tax-free. HSAs can be used for out-of-pocket medical, dental, and vision. HSAs can’t be used to pay health insurance premiums. HSA’s can only be used with… Read More

If you are under 30 or obtained a “hardship exemption” you qualify for a high deductible, low premium, catastrophic plan. Catastrophic health plans are the cheapest plan you can get that counts as minimum essential coverage. Catastrophic plans can be good for those who want cheap, barebones care. Catastrophic plans tend to trade a low… Read More

How does health insurance work? You pay a monthly premium and your share of annual out-of-pocket costs, and your insurer pays it’s share of covered costs.  The concept is simple, but getting that perfect health plan takes some brain power and elbow grease.  By taking the time to master and internalize the content of this page,… Read More

What is Actuarial Value? Actuarial value is average total of costs for covered benefits covered by a health plan. Let’s look at how ObamaCare’s metal plan actuarial values work and how actuarial value applies to all plans in general. FACT: Actuarial Value (AV) in regards to health insurance was created by the Affordable Care Act to rank ObamaCare’s… Read More

Shopping for Health Insurance Outside of the Health Insurance Marketplace If you make too much for cost assistance or want to see your private health plan options, you may want to shop outside of the Health Insurance Marketplace. There are three main ways to get covered in the individual and family market under the Affordable… Read More