WHAT IS HEALTH INSURANCE?

Health insurance is a contract between you and an insurance company. You buy a plan, and the company agrees to pay part of your medical costs when you get sick or hurt.

There are other important benefits of health insurance. Plans available in the Health Insurance Marketplace (and most other plans) provide free preventive care, like vaccines and check-ups. They also cover some costs for prescription drugs.

HEALTH INSURANCE HELPS YOU PAY FOR CARE

Did you know the average cost of a 3-day hospital stay is $30,000? Or that fixing a broken leg can cost up to $7,500? Having health coverage can help protect you from high, unexpected costs like these.

Your insurance policy or summary of benefits and coverage will show what types of care, treatments, and services your plan covers, including how much the insurance company will pay for different treatments in different situations.

WHAT YOU PAY FOR HEALTH INSURANCE

You’ll usually pay a premium every month for health coverage, and you may also have to meet a deductible each year. A deductible is the amount you owe for covered health care services before your health insurance or plan begins to pay. The deductible may not apply to all services.

How much you pay for your premium and deductible is based on the type of coverage you have.

Just as important as the premium cost and deductible is how much you have to pay when you get services.

Examples include:

• What you pay out-of-pocket for services after you pay the deductible (coinsurance or copayments)

• How much in total you’ll have to pay if you get sick (the out-of-pocket maximum)

The policy with the cheapest premium may not cover many services and treatments.