The last thing anyone needs to be told is that they need health insurance. The problem is, a decent health plan doesn’t come cheap. But there are ways to find affordable health insurance plans. It’s just takes a little smart shopping. A health insurance plan does 2 things: it makes sure you have access to healthcare, and it makes sure that healthcare is affordable. A health plan isn’t a blank check for your medical needs, though. With any plan, you’ll be responsible for some costs. Important health plan features that affect how much of those costs you’ll be responsible for include:

• Premiums. This is cost of keeping your plan in effect. Premiums are usually paid on a monthly basis. When you’re looking at plan premiums, keep in mind that what you’re seeing is a base price for the plan. Your premium could be adjusted based on your age and health status. Insurance companies call this “rating.” People who lead healthier lifestyles get more affordable premiums.
• Deductible. This is the amount you’ll have to pay before your plan starts picking up the rest of the bill. A deductible can range from a few hundred dollars to several thousand dollars. And a lower deductible isn’t always better — higher deductibles mean lower premiums. The question is, would you prefer to pay more in your monthly insurance bill, or when you receive care?
• Copayments and Coinsurance. These are amounts you’ll have to pay for any specific medical service you receive. Copayments are fixed amounts, such as “$20 per Office Visit” — meaning you’ll pay $20 out of your own pocket for a routine trip to the doctor. Coinsurance is a similar cost, but expressed as a percentage — “20% of Non-Emergency Hospital Care,” for example.
• Out-of-Pocket Maximums. Between your deductible, your copayments, and your coinsurance costs, staying healthy can add up to an expensive proposition. That’s why health plans include out-of-pocket maximums. Once you reach your out-of-pocket maximum, your health plan will pick up the rest of your healthcare costs (though some plans have exceptions to this — see below).

What Are You Paying For? Making Sense of Your Health Benefits

Before you buy a plan, a word of caution: every plan offers different coverage. Some plans won’t pay for basic care, but pick up the bill if you need major medical coverage. Others will only pay for routine trips to the doctor or dentist, and prescription medications.

Any time you look at a health plan, you’ll want to pay special attention to what it includes and excludes. For example, one common exclusion is maternity care. If you’re not planning on having children anytime soon, you’ll save money by enrolling in a plan that doesn’t offer maternity coverage. But if there’s a family in your future, you’ll want to steer clear of these plans.

To see exactly what a plan does and doesn’t cover, flip to the back of the plan brochure. You can compare plans and download brochures with our online health insurance quote service.

2 Crucial Parts of Any Health Insurance Plan

Near the back of any plan description you’ll find 2 sections: the Outline of Coverage and the Exclusions and Limitations.

The Outline of Coverage tells you exactly what your plan will pay for. It will also tell you how much of your medical bills you’ll be responsible for. There are 2 key things to keep an eye out for:

• Deductible waived means you won’t have to pay toward your plan deductible before coverage starts. Many plans will waive the deductible for routine care and basic lab work. (See above for more about deductibles.)
• Does Not Apply to Out-Of-Pocket Maximum means payments you make for certain services don’t count toward your out-of-pocket maximum. So even if you’ve reached your yearly out-of-pocket maximum, you’ll still be stuck paying the bill for certain services. So look closely to see which services have “Do Not Apply” next to them. (See above for more about out-of-pocket maximums.)

Once you’ve made sense of your Outline of Coverage, it’s time to turn the Limitations and Exclusions. This section can be hard to understand. It’s often written by lawyers, and is almost always in fine print. But it’s important to understand any plan’s exclusions before you enroll. Otherwise, you could be in for a nasty (and expensive) surprise later on.

That’s why working with a professional agent makes so much sense. It’s easy to look at health plans and see how it much costs each month, what the deductible is, or how much your copayments will be. But when it comes right down to choosing the best plan for your health needs — and your budget — nothing beats the expert advice of an insurance agent.

An insurance agent can take all that fine print and put it into plain-English. And an agent can help you see how much a plan will really cost — the one with the lowest premiums might not be the one that saves you the most money.

Finally, when you’ve settled on a plan, an agent can help you apply. Filling out an insurance application can make doing your taxes look easy. One accidental mistake can mean your application is rejected. Your insurance agent will make sure you’re application is filled out correctly and ready for approval.

Ready to find an affordable health plan of your own? Get started with online health insurance quotes. Use our simple online form to see which plans are available in your state.

Browse plans from leading health insurance carriers. Compare rates and benefits. And when you’re ready to narrow your search, let our network of licensed insurance agents help you make an informed health insurance decision.