Health insurance costs are generally made up of several key components:
- Premium: This is the monthly amount you pay for your health insurance coverage. Depending on your eligibility, you might receive a premium tax credit that can help pay for some or all of your Marketplace plan premium.
- Deductible: This refers to the sum you need to pay out of your own pocket for covered services before your insurance starts to pay. The deductible amount varies, and after it’s met, your policy’s coinsurance rate and copays kick in for your expenses.
- Copay: A copay is a set fee you pay for specific healthcare services. For instance, you might pay a $25 copay for a visit to your primary care doctor or a $100 copay for an urgent care visit. Generally, copays are charged after you’ve met your deductible.
- Coinsurance: After you’ve paid your deductible, coinsurance is the percentage of healthcare costs you’re responsible for. For example, under a silver-level Marketplace plan, you might pay 30% of the costs for covered healthcare services.
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