Health Insurance Coverage


 Health Insurance Coverage

What is health insurance and who should have it? Most people in the United States have health insurance as a means of paying for their medical bills. With Obamacare, this affordable health program became mandatory for most Americans in 2014. If you’re interested to learn more about what your current plan covers, how coverage options work or are taxed, here are 37 great sites to find an answer to any question you may have about health care reform.

Many things can contribute to a person's ability to pay their medical bills off-site, including lack of education and job income. The average individual aged 18-64 has $2,585 per year in medical debt that is more than half of their annual income, according to a study by the Consumer Financial Protection Bureau.

In order to find out how much you can expect to pay for health care, you must know how much your health insurance company will pay. Many people don't realize how much they are paying. The total amount that your insurer pays is called the "policyholder's share," and it varies from plan to plan. Your current policy may even have different deductibles and copays than the national averages listed below. Be sure to contact your insurance provider for details. Keep in mind, these are just national averages and depending on your plan, you may pay much more or much less than this amount.

Many health plans include a deductible which is the amount you will have to pay before your insurance company will start to help cover the cost of your health care bills. For example, you might have $500 deductible that you must pay out-of-pocket before any of your insurance benefits apply. So if you have a $1,000 medical bill and $500 deductible, you must use your own money to pay for half of that bill. This is why it’s important to know what your deductible is so you can set aside enough money.

In order to get the most value for your health insurance dollars, you want to make sure that you're getting as much coverage as possible for a level of cost that's comfortable for you. One way of doing this is through coinsurance. Coinsurance means that your insurance company will cover a percentage of your medical costs and you will need to pay the remainder. Coinsurance can be a good option because it means that, even if an unexpected bill comes up, you won't have to worry about paying the full amount yourself. However, it does mean that you'll have some out-of-pocket costs no matter what.

Another important thing to understand is that even if you don't have to pay your deductible, there are still copays which are usually small, fixed amounts that you will have to pay for non-emergency appointments and prescriptions. Copays usually range from $10-$50 but the amount can vary depending on the plan. Keep in mind that just because you don't have copays, doesn't mean that your insurance provider won’t cover the full cost of certain procedures. Copays are simply a fixed fee that you must pay each time you receive a particular service.

Health insurance plans and policies vary greatly across companies. Many plans have "in network" facilities and providers but some do not. Make sure that you know if your plan will cover the providers you want to see. Often times, you'll only be covered for medical services that occur inside your health insurance network. This is because your insurance company typically has agreements with certain facilities and doctors where they agree to pay a set amount for a given service, like $100 per doctor visit or $20 per prescription.

The next important thing to understand about health insurance is the difference between co-insurance and co-pays. While both of these terms mean that you are paying something towards your medical costs, there's an important distinction between these two concepts. Co-insurance means that you are paying a fixed percentage of your medical bill (say 30%) rather than the full amount. Co-pays refers to smaller, one-time fees that you must pay before your health insurance company will cover their share.

You can also learn more about how your insurance will affect your monthly budget by calculating out what benefits and co-pay costs you'll be facing on a monthly basis. It's important to remember that, regardless of what health care reform law says, insurance companies will still try to get as much money from you as possible. So if you're not getting the service or doctor that you need, be sure to call back and make some changes.

One way that individuals can make sure they’re getting the most from their health insurance plan is by getting a good, solid, comprehensive policy. Your health insurance policy should have enough coverage to cover medical needs (in case of an accident or illness) and should also include extended coverage options for things like prescriptions, eyeglasses and co-pays. The premiums on these plans tend to be higher than other plans as well. However, these plans generally include a great value for money as they often cover more benefits at a higher level than other policies.

In order for your policy to be comprehensive in all of your needs, it must have various kinds of coverage options. There are four different kinds of policies that are the standard and most common: bronze, silver, gold, and platinum. Each plan has a certain percentage of your medical expenses that will be covered by the insurance company, known as "actuarial value." In order to get better value for your money, you need to select a higher percentage for your out-of-pocket costs (i.e. a plan with higher actuarial value). Keep in mind that these plans pay less out-of-pocket if you use more health care services than someone on a plan with lower actuarial value because they are guaranteeing premiums no matter what level of coverage you require.

If you’re healthy and don’t go to the doctor very often, then you might want a bronze plan. Bronze plans are low cost because they only cover 60% of your medical expenses. If you have a higher deductible or copay, then you could end up paying more out-of-pocket for medical expenses than you’d like. If this is the case, then it might be better to get a silver plan which will cover 70% of your costs. The copays and deductibles on these plans are usually lower than those found on bronze plans. Silver plans are also more comprehensive in terms of benefits and coverage options.


We will hopefully do a more in-depth look at healthcare reform legislation at a later date, but for now, this is all you need to know in order to get started planning for your health insurance needs in the coming years. If you’d like to learn more about doing this on your own, there is a lot of information out there from various sources. We would recommend browsing through the Affordable Care Act implementation materials that the government has released by visiting and

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