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What you need to know about insurance

There is nothing more important than your health. A health issue can mean expensive medical bills. Health insurance can mitigate some of those costs and help you lead a more healthy life. Choosing the right health insurance for you and your family can be complicated. Determining what type of plan is best for your family is a personal decision. You will have to weigh the cost of the premium with the potential out-of-pocket costs related to your care and the flexibilities the plan provides. Here are some insurance basics to help you make a more informed decision.


Premium: The amount you pay for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance. 


Co-Pay: The fixed amount that you owe for covered healthcare services and can vary based on the visit type.


Deductible: The amount that you owe for covered healthcare services in a calendar year before their insurance company begins to share the cost.


Co-Insurance: is the variable (percentage) amount you must pay for covered healthcare services after you have met your deductible.


Out-of-pocket Maximum: The maximum amount you pay in a benefit year. Once this amount is met, the insurance pays all covered expenses for the remaining benefit year.


Another important component of choosing your health plan, is whether or not they are in-network with your providers. This means there is a contract in place between your provider and your health insurance. If there is not a contract in place, you will likely pay for the full cost of your care, and not be able to utilizes your health insurance benefits. Unfortunately, it is very difficult to assess whether or not we are in-network with your plan. Having a contract in place, does not always include every plan an insurance may offer.


The Plan Is ACA Compliant

By choosing a plan that is Affordable Care Act (ACA) compliant, you will maximize your coverage and avoid penalties.

You Understand Your Coverage

Make sure you understand your coverage.


To ensure that your benefits will apply at Carson Medical Group, verify by providing your insurance with Carson Medical Group’s Tax ID Number, 88-0133501.

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