How Health Insurance Works
How does insurance work?
No matter which plan you choose, you’ll pay a monthly payment (premium) to keep your health insurance coverage. You may also pay each time you receive medical care (co-payment or co-insurance). Generally, the more you pay per month (premium), the lower your deductibles and out-of-pocket costs.
When you’re looking at health insurance plans, the biggest differences are in the services they cover and how much they’ll pay for those services. With some plans, you’ll pay a certain amount when you have a service – that can be called a co-payment or coinsurance, depending on your plan.
If you have a deductible, that’s the amount you’ll have to pay for covered services before the insurance starts paying.
Most of the time, you’ll pay for part of your health care services until you’ve paid the “out of pocket maximum.” After that, the health insurance usually pays for covered expenses.