Health insurance can be incredibly costly in the United States, particularly when you factor in premiums, co-pays, deductibles, and other out-of-pocket expenses.
However, it’s important to know how much health insurance costs if you want to make smart financial decisions that will benefit your family long-term.
In this guide, we’ll take an in-depth look at health insurance costs throughout the country and help you find the plan that’s right for you.
Understanding Your Health Insurance Costs Under Obamacare As of January 2014, nearly 15 million Americans have gained health insurance coverage through state and federal exchanges created under President Obama’s Patient Protection and Affordable Care Act (ACA).
This has made health insurance a hot topic as millions are struggling to understand their new coverage and find affordable options.
With premium prices varying widely from state to state, knowing where your next health care dollar will be spent can help you manage your expenses and ensure you’re getting value for your hard-earned money.
What Is In-Network Coverage
When you get health insurance through an employer, or private insurer, you are in-network.
What does that mean? In-network providers agree to a contract with your insurer, and these providers will offer discounted services because they can directly bill them for reimbursement.
When you see an out-of-network provider, on the other hand, you have to pay up front and then submit claims for reimbursement from your insurer later on (or negotiate a direct payment plan with that provider).
An out-of-network doctor can cost significantly more than an in-network one—as much as double.
One of our biggest frustrations is when we’re forced to pay for out-of-network coverage and doctors.
Our research has found that, on average, patients are charged approximately 50% more for services rendered by an out-of-network doctor.
An independent Blue Cross Blue Shield Association report confirmed these findings, estimating that using an out-of-network doctor could lead to higher costs of up to $1,500 per year.
Be sure you know what your plan covers before heading into a hospital or doctor’s office.
Basic health insurance policies typically include a wide range of benefits, including prescription drugs, preventative care (such as flu shots and routine physicals), diagnostic services (like X-rays or lab tests), and surgical procedures.
If you’re suffering from a chronic illness that requires specialized treatments, like cancer or heart disease, many plans have special provisions to cover these expenses.
Some companies offer incentives for users who are living a healthy lifestyle—like joining an exercise club or eating well—in order to reward them for incorporating wellness habits into their lives.
Additionally, most health care policies come with co-pays on basic services to discourage unnecessary visits and keep medical costs down; if you use your benefits often, look for plans with lower out-of-pocket maximums.
Types of Plans
If you’re looking to purchase health insurance coverage, there are several types of plans available.
The most basic is called an HMO plan, or health maintenance organization.
These are group plans that require you to use certain doctors and hospitals for services and care.
An HMO is often a cheaper option for individuals who aren’t worried about being able to choose their own doctor or using facilities outside of their network.
However, if you have pre-existing conditions or a medical emergency, it can be difficult to get coverage from an HMO.
What is a Deductible?
The deductible is a part of your health insurance that you pay before your plan kicks in.
For example, if you have a $500 deductible and get sick, you’ll have to pay for all medical services up to $500.
After that, your insurance company will begin picking up its portion of payments, but it may not cover every service you receive.
Dental and vision care aren’t included as part of deductibles because those are separate plans.
In most cases, these are optional add-ons for people who want them—though employers often choose to offer them as well since they’re cheaper than many other health benefits.
The Pros and Cons of HSAs
An HSA, or health savings account, is a tax-advantaged way to save for qualified medical expenses.
It’s an alternative to a traditional medical flexible spending account and comes with more advantages than just being used for out-of-pocket expenses.
Although it’s only available to those with high-deductible health insurance plans and is also funded by your employer if you’re eligible, an HSA may be a great option for you if you’re looking for ways to supplement your current coverage and save on taxes.
However, before deciding whether or not an HSA will work best for you, it’s important to weigh its pros and cons.
What Are Coinsurance & Co-pays?
Coinsurance and co-pays are a way of paying for health care that can either be helpful or harmful, depending on how they’re implemented.
Coinsurance is a type of cost-sharing where you pay a percentage of your bill rather than a fixed amount—usually 20%. A coinsurance rate of 20% means that, if your hospital bill is $1,000 and your coinsurance rate is 20%, you will owe $200 instead of being billed for $1,000.
Co-pays are similar to coinsurance rates but work differently because they require you to pay fixed amounts—say $25—for certain types of medical services or prescriptions.
Medical vs. Surgical Expenses
Medical costs are typically higher than surgical expenses, and as such, you might want to consider focusing on one option for your surgery.
If your goal is to pay for your surgery outright or finance it at a low interest rate, then you’ll want to look into financing medical procedures.
However, if you’re looking for a more affordable means of paying for breast augmentation surgery (i.e., by having someone else cover it), then you might want to go with a surgical procedure that does not require an overnight hospital stay.
Both options will still produce great results! Do some research online before deciding which route is best for you.
How much is health insurance in America per month
It’s also possible to purchase health insurance through a healthcare exchange.
The Affordable Care Act (ACA) created a number of these exchanges, which are basically marketplaces for health insurance.
Enrollment for these plans was closed on January 31, 2017 for 2017 coverage; however, it will open again in November 2017 for those who wish to purchase coverage during 2018 enrollment.
To find out more about ACA exchanges and how to enroll if you meet certain criteria, visit Healthcare.gov or read our guide on buying health insurance online.