Buying health insurance for yourself and your family can be difficult. We have developed a easy-to-use-tool to help you find the right plan. Here are some things to know as you use the tool:
- There are four categories (Metal Tiers): Catastrophic, Bronze, Silver, and Gold. They are based on how you and your insurance plan split costs and have nothing to do with quality of care.
- You can purchase plans on-exchange or off-exchange. On-exchange means those plans that are available on HealthCare.gov only. If you qualify for a subsidy, and choose to use it on your health plan, then you will want to shop on-exchange. Off-exchange means those plans that are available in the open market, directly through an insurer.
- MOOP (maximum-out-of-pocket) is the most you will have to pay during a policy period (usually a year) for health care services. Once you have reached your out-of-pocket maximum, your plan begins to pay 100 percent of the allowed amount for covered services. The out-of-pocket limit doesn't include your monthly premiums. It also does not include anything you may spend for services your plan does not cover.
- The deductible is the amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself. After you pay your deductible, you usually pay only a copayment or coinsurance for covered services. Your insurance company pays the rest.
- PCP Copay/Coinsurance is the amount you will pay to visit your primary care provider.
- Specialist Copay/Coinsurance is the amount you will pay to visit a specialist for covered care.
- In/Outpatient Surgery/Facility is the amount you will pay for covered inpatient or outpatient surgery.
- Premium is the monthly amount that you must pay for the insurance policy.