The Basics of Health Insurance

Your health is your most treasured asset, and protecting it is a top priority. Comprehensive health insurance is not only for when you become sick or injured, it also plays an important role in maintaining your health. To understand how health insurance works, start by recognizing the key components of your policy.

The premium is the fee you pay to maintain health insurance coverage. If you are covered through your workplace, your employer likely pays a portion or majority of this fee, and the remainder is deducted each pay period. Similarly, a premium is paid for health insurance obtained through the Affordable Care Act as well as Medicare after retirement.

The deductible is the amount of money you pay out of pocket before your health insurance is responsible for payment.  A deductible can be for an individual or for a family. For example, if you have a $5000 family deductible, you will pay the first $5000 of your medical expenses including charges from doctors, medical facilities, laboratory and imaging providers, or prescriptions. Your health insurance will then pay a percentage of charges thereafter. As a rule, higher premiums result in lower deductibles.

The copay is a set charge you pay for each covered medical treatment, usually at the time the treatment is provided. An example may be a $25 charge for each visit to your primary care provider, and $50 for each visit to a specialty provider. Copays do count toward meeting your deductible.

An exclusion is a non-covered expense. This may include certain providers, unapproved or experimental treatments, or elective surgery such as cosmetic procedures.

Coverage limits involve an insurance company setting a maximum amount they will pay over a period of time (annual) or lifetime. These are usually between $500,000 and $1 million dollars. The policyholder then becomes responsible for all costs beyond that set limit.

Insurance companies will categorize providers as in-network and out-of-network. In-network providers have negotiated reduced fees with the insurance company, and this means lower cost to the insured. If a provider has not negotiated a discount with the insurance company, it is classified as out-of-network and those costs are passed along to the patient in the form of less coverage and higher copays.

Health insurance protects more than your physical health. It can protect your real world assets. Medical bills resulting in from serious illness or traumatic injury can be hundreds of thousands of dollars. A health insurance policy can prevent a loss of your life savings or bankruptcy from unexpected medical costs.

At. Watson Imaging Center, we will work with your health insurance provider to provide the best possible service at the lowest possible cost to you. Your well-being is in good hands at Watson Imaging Center. Call us today at 314-781-9711.