If you have a full-time job, chances are your employer pays for your health insurance. Your contribution through bonuses is usually taken directly from your salary. Until you need it, you probably don’t think twice.
But what if your employer doesn’t pay your health insurance? What if you are self-employed? If you have to find and pay for your own health insurance, it’s important that you know how to pay your health insurance premiums. Learn more now with Benzinga’s guide.
Payment of health insurance premiums on HealthCare.gov
Paying your initial premiums on Healthcare.gov is easy if you have internet access. It’s as simple as:
- Log in to your Healthcare.gov account
- Choose your application (you will find it under Existing applications)
- By clicking on the blue button that says “Pay your first monthly health insurance premium”.
- “Pay for Health Plan Now” (the green button)
If your online payment is unsuccessful, your account is not ready. Contact us by email or phone for next steps.
What is health insurance?
Like car insurance covers your car, health insurance is there for you in case of illness or injury. Typical health insurance policies are sold by most major insurance companies that pay for things like:
- Chronic disease
- Prescription drugs
- Psychological services
- Physiotherapy and Occupational Therapy
- Long and short term care
Health insurance is there for you if you get sick or injured in an accident, but it also covers preventive measures, such as doctor visits, screenings and tests. Many policies also offer hearing, vision and dental benefits, although these can sometimes be added later.
Health insurance is not free. For your health insurance, you make payments called premiums, usually in monthly instalments. Even if you have health insurance through your employer, you typically make health insurance payments every month, even if they come directly from your paycheck.
When it comes time for you to use your health insurance, it’s not free either. There are fees and expenses, including:
- Franchises: Each time you use your health insurance, you must pay a deductible. A deductible is the insured’s contribution to medical costs. Deductibles are not required each time you use your health insurance, but they usually have an annual matching amount. When it comes to your health insurance costs, the higher the deductible, the lower the premiums – and vice versa. Deductibles reset on an annual basis.
- Co-payments: A co-payment is a lump sum you pay each time you see your doctor or specialist or receive specific types of health services. Typical copays start around $10 but can go up to $35. Copayments also apply to prescription drugs, although many health plans do not require a copayment when you see your primary care physician or for prescription drugs.
- coinsurance: First you pay your deductible, then there is coinsurance. For example, let’s say your deductible is $500 and your coinsurance is $5,000. If you need surgery, you pay the $500 deductible first. If the procedure costs $50,000 and your coinsurance is 20%, you pay $10,000 and your health insurance provider pays the remaining $40,000. High coinsurance costs generally correspond to lower premiums.
Types of health insurance
There are two main types of health insurance: public and private. While public health care plans like Medicare and Medicaid are government programs, private plans are paid for either by the individual or their employer.
Private health insurance
Private health insurance is broken down into four main categories: HMO, PPO, EPO and POS.
- HMO (Health Maintenance Organization): HMOs have their own networks of hospitals, doctors and healthcare providers. HMO policyholders must remain in this network to receive coverage. Since the insurance company enters into agreements with providers within the network, HMOs are generally more affordable.
- PPO (Preferred Provider Organization): While with an HMO you have to stay in your network, a PPO allows you to choose your own doctor and healthcare providers. With a PPO, you can see any doctor you want. Because of these less restrictive requirements, PPOs are more expensive than HMOs and often come with a higher coinsurance rate.
- EPO (Exclusive Supplier Organization): Like an HMO, an EPO offers a local network of service providers from which the policyholder can choose. EPO plans are good for people who don’t plan to use their health care that often. EPOs offer higher deductibles and more affordable premiums.
- POS (point of service plan): A POS is a managed health care plan that is kind of a hybrid between an HMO and a PPO. Like an HMO, the policyholder has a list of in-network providers. The insured must pay for providers who are not part of the network, but what differentiates a point of sale from an HMO is that he will pay for services outside the network if a recommendation is made by his primary care physician.
Public health insurance
Public health insurance includes all types of coverage provided by the government: federal, state, and local. The main types of public health insurance include:
- Health Insurance
- Medical help
- CHIP (Children’s Health Insurance Program)
- VA (Veterans Administration)
- IHS (Indian Health Service)
While Medicare is a federal program for people age 65 or older (and those with long-term disabilities), Medicaid is free to those who qualify and is administered at the state level. CHIP is available for children from low-income families who are not eligible for Medicaid. The Veterans Administration provides medical assistance to eligible U.S. military veterans, while CHAMP-VA, administered by the Department of Veterans Affairs, also covers veterans, their dependents, and survivors.
Other state and local government health services are provided through public hospitals and clinics. While not technically health insurance, they do provide financial and medical assistance to those who qualify.
What is a health insurance premium?
Your health insurance premium is the amount you pay each month for your health insurance. The amount you pay depends on:
- Your age
- Your health
- Diet type
- Habits like drinking and smoking
- Coverage amount
- Deductible amount
Health insurance is funded by your monthly premiums, but premiums don’t cover everything. In addition to premiums, when you use your insurance, you must pay an annual deductible.
There is also coinsurance and copays. The price of your premiums can sometimes be reduced through a premium tax credit. If you have Medicare, you may qualify for the Medicare Savings Plan, which pays some or all of your monthly premiums.
Who pays your health insurance premiums?
Who pays your health insurance premiums depends on the type of insurance you have. If you have a group policy such as through your employer, your employer pays your insurance premiums with funds from your paycheck. If you have an individual policy, you pay the premiums.
If you have public health insurance like Medicare Part A, hospitalization is free. Parts B and D (medical services and prescription drugs) are paid for by the beneficiary. Public health insurance like Medicaid is free, but hard to get. Even if you don’t qualify for Medicaid, your child may qualify for CHIP.
Benefits of Lump Sum Health Insurance Payments
Capital health insurance is more popular than ever. Lump-sum payments increase efficiency and quality of care. Lump-sum payments help improve coordination between medical institutions and make cancer screening and treatment more effective and affordable. Lump sum payments help reduce deductibles and out-of-pocket expenses.
Lump sum payments also help those who suffer a debilitating injury or illness such as a sudden heart attack or stroke. Prepayment allows the insured to focus 100% on collection, without paying bills and wondering if they have paid their premiums.
It also helps defer costs at the time like deductibles and coinsurance. Cash benefits are paid directly to the insured and can be used as the policyholder sees fit. Flat-rate health insurance premiums cover:
- Prescription drugs
- Unforeseen expenses
Cash benefits can even pay for household expenses such as rent, mortgages and utilities while the insured is incapacitated.
Compare health insurance
When it comes to comparing health insurance premiums, knowledge is king. Benzinga has a wide range of health insurance articles, from what to look for in an insurance policy, what type of insurance is best for you, and most importantly, how to lower those premiums. health insurance.
The bottom line is, no matter how good the policy, if you can’t pay your monthly premiums, you may end up with the bag. Compare health insurance plans below.
Educational guides for health insurance
Whether you’re looking for private health insurance, it’s time to enroll in Medicare, or you need temporary help now, Benzinga has countless articles and educational guides on health insurance and insurance premiums. disease. Check out these great health insurance educational guides from Benzinga.
Frequently Asked Questions
Why is my monthly health insurance premium so high?
Why is my monthly health insurance premium so high?
Philip Loyd, Licensed Insurance Agent
If your health insurance premium is abnormally high, you might want to shop around. Spending time getting the best deal is not a waste of time at all. Unfortunately, if you fall into a high-risk category, even price shopping may not lower your premiums. If you suffer from a chronic illness, have pre-existing conditions or are a smoker, your premiums will naturally be high. Some states also have higher monthly premiums.