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Introduction

Insurance is a big word, and it can be confusing to understand how your health coverage works. One of the most basic concepts of insurance is “coverage.” If you have 80% coverage, that means that 80% of the cost for a covered service will be paid by your insurance company. The other 20% might come from you—either through deductibles or co-insurance rates (or both). It may seem like a small difference between 80% and 100%, but here’s why it matters:

Insurance will cover most of the cost of a covered illness or injury.

When you’re insured, your insurance company will pay for 80% of the cost of a covered illness or injury. This is called coverage.

The remaining 20% is called your responsibility. It can be a copayment, coinsurance, or deductible—which all mean you have to pay for part of the cost yourself. In other words, if your doctor charges $100 for an office visit and your health plan pays 80%, then you’ll have to pay $20 out-of-pocket (or whatever co-insurance rate applies). That’s why it’s important to know what each type of payment means before choosing a health plan. Because nothing can be clearer than this: Don’t think that just because something is insured doesn’t mean it won’t cost money! You still need to consider the financial impacts of coverage on what could otherwise be uncovered by insurance—and not just after you’ve filed a claim with your insurer but before purchasing any policy in order to make sure those costs don’t go beyond what’s best suited for both parties involved!

You may have to pay more out-of-pocket than you think.

Deductibles are one of the most important factors to consider when deciding on a health insurance plan. They’re essentially a set amount you have to pay before the insurance company starts paying for services. The higher your deductible is, the more you’ll have to pay out-of-pocket for medical care.

Deductibles can be different for different types of coverage. For example, someone with a high-deductible plan may not have any payments under their deductible until they reach levels of $5,000 or $10,000; while someone with lower deductibles might start paying once they reach levels like $50 or $100. Deductibles also vary year over year and carrier to carrier so it’s important to check them each time before choosing an insurance plan that fits your needs best!

The deductible is different from the co-insurance rate.

The deductible is the amount you have to pay before your insurance company starts to pay. For example, if your deductible is $500 and you get a $1,000 bill from the doctor, then you’ll only have to pay $500.

The co-insurance rate refers to the percentage of costs that you must share with your insurance company once your deductible has been met. As an example, if your insurer’s co-insurance rate is 20%, then this means that after spending money on deductibles and copays (which are discussed below), they will cover 80% of what remains on any given visit or treatment.

Co-pays are small fees that patients must pay for each office visit or prescription refill; these payments usually aren’t deducted from their total amount owed until later when bills come in from doctors or pharmacies. The good news here is that by having health insurance with a low deductible and high co-insurance percentage—or even better yet: no deductible at all—you’ll be able to avoid these extra expenses altogether because they won’t apply until after meeting certain thresholds defined by federal guidelines established by The Patient Protection And Affordable Care Act (ACA).

Read the details of your plan to understand how you’ll be billed.

Before purchasing a health insurance policy, it’s important to understand what your plan will and won’t cover. Your health insurance company might call this “coverage.” The details can be confusing, but once you know what to look for, it’s easy to spot the important stuff in your plan.

The first step is understanding how much of a bill you’ll pay out-of-pocket. You’ll want to find out if there’s an annual deductible ($1,000) or separate deductibles for each type of service (such as primary care visits and prescription drugs). For example: If you need surgery for a broken leg and don’t meet the annual deductible ($1,000), then 80% coverage would only apply after meeting that amount—so $800 of your medical bills would still come from your pocketbook.

When you understand the terms of your insurance, you’ll be better prepared when you get an invoice.

If you want to understand the terms of your insurance, you should know what you are and are not covered for. You also need to be aware of how much you will have to pay out of pocket and how much monthly.

When an insurance policy says it covers 80% of medical expenses, that means that the insurer will pay for 80% of those costs. You’re responsible for paying the rest out of pocket or with a secondary payment method like health savings account (HSA) funds or flex spending accounts (FSA).

Conclusion

As we’ve seen, insurance is complicated and there are many different options. If you’re looking for health insurance, it’s important to understand how much coverage you need and what it means for your out-of-pocket costs. If you’re considering a new plan or renewing an existing one, check with your current carrier first. Your agent or broker can help make sure that the policy fits into your budget while meeting all of your needs

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