Understanding the total cost of using your health plan
Choosing a health plan is a very important decision. It’s one that you should fully research before making your choice. HAP is here to help you uncover the real costs of using your health plan.
What are the
additional costs
Costs you are responsible for over and above your monthly premium. These expenses for medical care are not paid for by insurance and are commonly known as out-of-pocket costs.
of using your health care plan?
{
premium
The monthly payment made to your health plan for coverage.
+
deductible
The dollar amount that a member must pay for eligible health expenses before a health plan will begin payment for medical services.
+
coinsurance
Your share of the costs of a covered health care service, calculated as a percent (for example 20%) of the allowed amount for the service.
For example, if your plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your coinsurance payment of 20% would be $20. The health plan pays the rest of the allowed amount.
+
copays
A fee paid by the member at the time of service. Typical copays are for physician office visits, emergency room or urgent care visits, and prescription drugs.
}
=
your total cost
Here's an example:
Ben's back was injured in an accident last month and his doctor wants him to get some x-rays.
The following comparison shows the real cost of the x-rays and how much Ben will pay:
