Healthcare coverage is a way to help you pay for medical care while providing you access to a network of doctors and hospitals.
First, you buy a health plan. A health plan determines the types of medical services you are covered for and how much you will pay when you get care.
When you need medical care, you visit a doctor or hospital in your plan's provider network. This is a group of doctors and hospitals that have agreed with the health insurance company to charge certain amounts for each service. Your costs for care are usually lower when using network providers. Having health coverage can save you money each time you get care.
Healthcare coverage isn't just for when you're sick. Preventive care services can help keep you and your family healthy by monitoring your health and catching problems early when they may be more easily treated.
Each month, you pay a premium for your health plan. The amount depends on the plan you buy. The lower your plan's premium, the more you typically pay when you see the doctor and vice versa. Understanding how often you see a doctor can help you choose the right plan for you.
It depends on the service. Some services have a copayment, which is a fixed dollar amount. Other services have a coinsurance, which is a fixed percentage amount. When you get care from a network doctor, you pay the copayment or coinsurance and the health plan pays the rest up to the allowable amount.*
Some health plans have an annual deductible, which is the amount of money you pay for services before the coinsurance and health plan begin paying for them.
To protect you and your family from unexpected costs, most plans have an annual out-of-pocket maximum. Once you reach the out-of-pocket maximum, your health plan covers 100% up to the allowable amount for most covered medical services.
*Although some plans let you get care from hospitals and doctors who aren't in the plan's network, you'll pay more to see those non-network providers. The plan may also have other costs, such as a separate, higher deductible, for seeing these providers. These extra costs can be very high, so it's smart to get care from network providers.
Everyone's different. That's why we offer a wide range of health plan options. Learn more about the plans that are available to you.
Open enrollment ended January 31. You must have experienced a life event to apply for coverage at this time.Learn More
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Open enrollment ended January 31, but you may still qualify for health coverage if you’ve experienced one of the life events below. If you don’t have a qualifying life event, you can apply for coverage during the next open enrollment period starting in the Fall 2017.