Where Do Your Health Care Dollars Go?

December 28, 2019

Plan Premiums are the “entry fees” for health insurance and are paid by all policyholders. If you get your Health Care through your employer, a portion of your premium may be paid by the company. Premiums are simply the cost of purchasing an insurance policy. They do not apply to your deductible, and do not apply directly to the cost of your care. Deductibles are the cumulative amounts each covered individual or family must pay before an insurance plan begins to pay out against claims. Individual health plan policyholders pay for their Health Care in full until their cumulative expenses meet their deductible amount. After meeting their deductible, insurance pays for all or a percentage of Health Care costs, depending on whether or not the plan requires co-insurance (see below). For example, if your plan has a co-insurance requirement of 20%, once your deductible has been met, you pay only 20% of costs going forward, until the maximum out-of-pocket limit is reached, after which your insurance plan pays 100% of costs. Family health plans have both individual and family deductibles. Once an individual meets their individual deductible amount, Health Care expenses are then applied to their famil

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