Health Insurance FAQs
1. What is a health insurance premium?
A health insurance premium is the amount you pay for your health insurance coverage. It's typically paid monthly, quarterly, or annually.
2. What is a deductible?
A deductible is the amount you must pay out of pocket for covered medical expenses before your insurance starts to pay.
3. What is a copayment?
A copayment, or copay, is a fixed amount you pay for covered services at the time of service. For example, you might have a $20 copay for doctor visits.
4. What is coinsurance?
Coinsurance is the percentage of costs you pay for covered services after you've met your deductible. For example, if your coinsurance is 20%, you would pay 20% of the cost for covered services, and your insurance would pay the remaining 80%.
5. What is a network?
A network is a group of doctors, hospitals, and other healthcare providers that have agreed to provide services to members of a specific health insurance plan.
6. What is an out-of-network provider?
An out-of-network provider is a healthcare provider that does not have a contract with your health insurance plan. If you see an out-of-network provider, you may have to pay higher out-of-pocket costs or the full cost of the service.
7. What is a pre-existing condition?
A pre-existing condition is a health problem that existed before you applied for health insurance coverage. Under the Affordable Care Act, health insurance plans cannot deny coverage or charge higher premiums based on pre-existing conditions.
8. What is a health savings account (HSA)?
A health savings account is a tax-advantaged savings account that you can use to pay for qualified medical expenses. HSAs are available to individuals with high-deductible health plans.
9. What is a premium tax credit?
A premium tax credit is a subsidy available to help eligible individuals and families with low to moderate incomes afford health insurance coverage purchased through the health insurance marketplace.
10. When can I enroll in health insurance?
In the United States, you can typically enroll in health insurance during the annual open enrollment period, which usually runs from November 1 to December 15. However, certain life events, such as getting married or having a baby, may qualify you for a special enrollment period outside of the annual open enrollment period.
11. What is a marketplace?
Often referred to as a health insurance marketplace or exchange, a marketplace is a platform where individuals and small businesses can shop for and purchase health insurance plans. These marketplaces were established as part of the Affordable Care Act (ACA) in the United States to provide a centralized location for people to compare different insurance options and enroll in a plan that best fits their needs and budget. Want to check Marketplace pricing?
These are just a few common questions about health insurance, but there are many more aspects to consider when choosing and using health insurance coverage.