SunGate Insurance Agency Blog
With health care costs rising, it is safe to say that buying health insurance is a practical choice. While a lot of insurers offer health insurance products, it can get very confusing. Research studies suggest that about 50% of 19- to 30-year-old adults can’t explain some of the basic health insurance terms, such as deductibles and coinsurance. That means that they may make serious mistakes when purchasing coverage and we don’t want that to happen so here are the most important things to understand.
Insurance premiums are the periodic payments you need to make to maintain a policy.
A deductible is an amount you pay out-of-pocket for the medical services you obtained before your policy will take effect.
Take, for instance, if your health plan has a $1,500 deductible, your insurer won’t reimburse you for the bills until your deductible is spent. Note that this may not apply to certain preventive healthcare services like vaccines and wellness checkups.
Coinsurance is your share of any medical service claims. For instance, you might shoulder 20% of the cost of medical service, and your insurance pays for the remaining 80%. You will then start paying coinsurance as soon as your deductibles are met.
More often, lower insurance premiums come with higher coinsurance.
Some insurers may require you to pay a co-pay (usually a flat rate) to your health care provider for certain services. Take, for example, if your policy requires you to co-pay $30 for every doctor’s visit, then you’ll need to shell out $30 every time you visit your doctor. Bear in mind that co-pays are usually higher if you visit specialists or the ER.
More often, health plans may require you co-pays and coinsurance. Co-pays are common when buying prescription drugs. If you regularly see a doctor for medications and chronic health condition, choose a plan with low co-pay for these services.
Health Insurance Enrollment
In general, you can sign up for health insurance during open enrollment period only. However, you may enroll at other times if you are eligible for an exception. Exceptions are usually granted for many reasons which include marriage or divorce, pregnancy, or moving to another state.
Having Your Own Health Insurance
You can be covered by your parents’ health insurance until you’re 26 years old. You are eligible for special enrollment if your birthday falls outside open enrollment period. So before your 26th birthday, start shopping for your health plan to avoid gaps in your coverage.
Being Covered By 2 Health Plans
If you have two health insurance plans, one plan should be primary while the other is secondary. When you have insurance through employment and your parents’ health plan, your work plan will be your primary and you parents’ plan will be your secondary.
The primary plan will pay for your claims less the deductible, copay, and coinsurance. Your secondary plan, on the other hand, will pay the unpaid balance after your deductible is met.
Health insurance coverage is important because you’ll never know when sickness will hit you. Here at Sungate Insurance, we want you to be covered with reliable health insurance policies for a reasonable price. Our agents will be happy to assist you with your insurance needs. Get quoted for free! Call us at (407) 878-7979 or visit us at our office today!
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