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Cost Guide

Understanding Your Costs

Premiums, deductibles, copays, coinsurance — here's what you actually pay when you use healthcare and how it all works together.

How Costs Flow
Understanding when you pay what

Premium

Pay monthly

Deductible

Pay first $X

Copay/Coinsurance

Share costs

OOP Max

Insurance pays 100%

Key Terms Explained

💵Premium

The amount you pay every month for your health insurance, whether you use it or not.

Example: If your premium is $400/month, you pay $4,800/year just to have coverage.

💡 Tip: Subsidies can significantly reduce your premium. A $400 plan might only cost $100 after tax credits.

🎯Deductible

The amount you pay out-of-pocket before your insurance starts paying for covered services.

Example: With a $2,000 deductible, you pay the first $2,000 of your medical bills. After that, insurance kicks in.

💡 Tip: Preventive care (annual checkups, vaccines) is usually free even before you meet your deductible.

🏥Copay

A fixed amount you pay for a covered service at the time of the visit.

Example: $30 copay for a doctor visit means you pay $30 at the office, regardless of the total bill.

💡 Tip: Copays are predictable and often apply even before meeting your deductible for some plans.

📊Coinsurance

Your share of costs after you've met your deductible, expressed as a percentage.

Example: With 20% coinsurance, if a procedure costs $1,000, you pay $200 and insurance pays $800.

💡 Tip: Coinsurance continues until you hit your out-of-pocket maximum.

🛡️Out-of-Pocket Maximum

The most you'll pay for covered services in a year. After this, insurance pays 100%.

Example: With an $8,000 OOP max, once you've paid $8,000 in deductibles, copays, and coinsurance, everything else is free.

💡 Tip: This is your financial safety net. In 2024, the ACA limit is $9,450 for individuals.

Real-World Example

A Year with a Silver Plan
$350/month premium, $2,500 deductible, 20% coinsurance, $8,000 OOP max

Annual Premiums

$350 × 12 months

$4,200

Scenario A: Healthy Year (2 doctor visits)

Premiums:$4,200
Doctor visits (preventive = free):$0
Total Paid:$4,200

Scenario B: Moderate Use (ER visit + surgery)

Premiums:$4,200
Deductible (you pay first $2,500):$2,500
Surgery: $15,000 × 20% coinsurance:$3,000
Total Paid:$9,700

Scenario C: Major Health Event ($100,000 in bills)

Premiums:$4,200
Out-of-pocket costs (capped at OOP max):$8,000
Insurance paid:$92,000
Total You Paid:$12,200

The OOP max protected you from $92,000 in medical bills!

Key Takeaways
  • Lower premium = higher costs when sick. Bronze plans save money monthly but cost more if you need care.
  • The OOP max is your safety net. No matter how sick you get, you won't pay more than this in a year.
  • Preventive care is free. Annual checkups, vaccines, and screenings are covered 100% before deductible.
  • Estimate your total costs. Don't just look at premiums — consider potential medical expenses too.