Health Insurance Cost ConsiderationsHealth Insurance Cost Considerations Deductibles, Co-Payments, and CoinsuranceYou will nearly certainly pay a deductible before the health insurance plan will chip in for your health care. This is usually an annual amount, which can range from $100 to several thousand dollars. Co-payments are charged for medical services individually. For example, a doctor visit might have a $30 co-payment per visit or a prescription may have a $10 co-payment for each medication. Coinsurance is not part of every health insurance policy, but it is the percentage you must pay after the deductible is met. If coinsurance is part of your policy, you might be responsible for 20% or more of the cost of medical care (after the deductible). Out-of-Pocket MaximumThis limits the amount you will have to pay for medical expenses. This is especially important with a health insurance policy that includes coinsurance. For instance, if your insurance requires you to pay 20% of the charge and you need $500,000 in medical treatment, you will have to pay the deductible plus $100,000. Medical needs that cost $500,000 or more are not unusual, but paying a $100,000 bill individually is out of reach for many people. You need to be able to afford the out-of-pocket maximum, stop-loss, or coinsurance maximum. For example, a policy might have 20% coinsurance up to $15,000 and pay for 100% of expenses over $15,000. That means you would only be responsible for a maximum of $3,000 plus your deductible. Benefit CeilingThis is also called the maximum lifetime payout. Health insurance companies in will set a lifetime limit for your medical expenses. At least $1,000,000 in coverage is recommended. Health care is extremely expensive and the costs are rising, so a million dollars isn't as much as it sounds like. A severe illness, accident, or surgical need can cost well over $1,000,000 in treatments. |