Consumer Guide to Health Care
Health Insurance: Checkup on Costs
There are two main types of costs to think about:
Be careful to think about the second question as well as the
first because plans with the lowest monthly premiums may end up
costing you far more if you actually need health care. These costs
can include one or more of the following:
Deductible: the amount you pay for covered services before
the health plan begins paying its share.
Coinsurance: the percentage of charges you must pay for
each service you receive.
Copayment: a specific dollar amount you must pay for each
service you receive.
Also, keep in mind that some plans may put a limit on the amount
you are required to pay each year (known as an out-of-pocket
limit) but there may be differences on which of your expenses
are included in this limit.
So, think carefully about the different types of health care you
currently need or might need in the future.
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Plan A |
Plan B |
Plan C |
| How much will the
premium cost me each month? |
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| If there is a
deductible, how much will I have to pay before the
plan starts to pay for medical care? |
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| If there is a
deductible, how much will I have to pay before the
plan starts to pay for prescription medicines? |
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| How much will I have to
pay (coninsurance or co-payment) for each doctor visit? |
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| How much will I have to
pay (coinsurance or co-payment) for each hospital
stay? |
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| How much will I have to
pay (coinsurance or co-payment) for each prescription? |
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| How much more will I
need to pay if I go outside the health plan's
network of doctors, hospitals, and other providers
to get services? |
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This checklist is a modified version of one created by the
Agency for Healthcare Research and Quality.
Choosing a Health Plan. Your Guide to Choosing
Quality Health Care. AHCPR
Publication No. 99-0012, July 2001. Agency for
Healthcare Research and Quality, Rockville, MD.
Last Revised:
March 27, 2013
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