Health Insurance Plan

Frequently Asked Questions About Your Health Insurance Plan

Health Insurance can be confusing at times. So, we have complied some frequently asked questions and their answers to help you better understand your health insurance plan and options.

What’s the difference between a deductible, a co-payment and coinsurance? 

These are all costs you will pay out of your pocket. The deductible is the amount you must pay first before your insurance begins to pay. This is yearly so each year you must meet your deductible first.

A Co-pay is the fixed amount you pay for a service. Each service would have a different fixed amount.

Co-insurance is a fixed percentage that you pay toward a service. A common percentage used is 20%. This means you would be responsible for 20% of the cost of the service.

What’s the difference between in network and out of network?

When you go to a health care provider who accepts your insurance plan, this is called in network. When you go to a health care provider who does not accept your insurance plan, this is what is called out of network.

What is Critical illness insurance?

This type of plan covers very specific illnesses that tend to be expensive and impact your life in such a way that it effects your income and your ability to work. Examples would be Cancer, Stroke and Alzheimer’s Disease. Every policy is different as to what illnesses are covered. These policies tend to pay a lump sum amount when you are diagnosed with a covered illness.

When would I need a Short-Term health insurance plan?

This type of insurance is usually temporary and are used when you and your health care coverage are in transition. It provides coverage for less than 1 year. Here are some examples of when you might need short term insurance

  • You are in between jobs.
  • You started a new job but have to wait until you are able to have coverage with your new employer.
  • You lost coverage due to a divorce
  • Waiting for Medicare or ACA coverage to begin


Health Insurance Plan

What should I ask when choosing about with looking for a health insurance plan?

1 What type of plan is this – is it an HMO, PPO?

2 What are the costs – monthly premium, co-pays, deductibles and other costs

3 What are the benefits- what is covered and not covered by the plan

4 Can I keep my current health care providers – you will want to know if your providers accept the plan you are considering

5 What about annual exams – you will want to know if routine exams are covered


If you need help understanding when your health insurance plan covers and does not cover please Contact Us