I need help purchasing health insurance. ?

-I have never bought insurance before. I have no idea what I'm looking for. I don't know how the deductibles work, do I pay that up front? I don't know co insurance is? Could anyone give me some information on what to look for? It's much appreciated.The deductible is a flat dollar amount that you must pay. If your deductible is $500.00 and you receive a service up to $500.00 that is subject to deductible, the allowed amount (a negotiated price) will be applied to your deductible. Ex.: the doctor charge is $125.00. The insurance company's allowed amount is $42.00. You owe the doctor $42.00. If the doctor has a contract with the insurance company, he/she will write off the remaining balance.



Not all services are subject to deductible. Many routine services such as physicals, mammograms, PAP smears, etc. are not.



Most doctors/hospitals will not make you pay the deductible up front. They will wait until the claim processes through the insurance company.



Coinsurance refers to the percentage of the cost that you owe. For instance. a service is covered at 80% of the allowed amount after deductible. That means that after your deductible is met, the insurance company will cover 80% of the remaining allowed amount. You would be responsible for 20% of the remaining allowed amount.



So let's say you go to an in-network doctor and get a $3,000 medically necessary (versus routine) colonoscopy. Here's how you figure out your patient responsibility using the numbers I mentioned:



The charge is $3,000.00, but the insurance company's allowed amount is $1,200.00. You take the allowed amount of $1,200.00 and subtract the $500.00 deductible; this leaves $700.00. This post-deductible portion is now covered at the coinsurance rate of 80%, so that means the insurance company will pay $560.00 ($700.00 times 80%). Your coinsurance is 20% of $700.00, or $140.00.



Your total patient responsibility, then, is $640.00 ($500.00 deductible plus $140.00 coinsurance).The premium is the only thing that you pay up front. It is paid monthly.



You do not pay anything else until you actually use the insurance.



When you get medical care, you pay full price, until the total of those payments equals the deductible. After that you pay only the co insurance.



For example, if the deductible is $5000, the coinsurance is 20%, you go to the hospital 10 times, and the hospital charges $1000 each time:

The first 5 times, you pay the full $1000, because you have not yet paid the deductible.

After those 5 payments, you have paid the deductible, so you only pay the 20% coinsurance ($200 each time) for the last 5 times.
You clearly are looking for the exact services that an agent would provide. You need an agent near you, and you can find one, typing in your zip code to www.iiaba.net and then THEY, for no extra cost, can show you a variety of plans, explain coinsurance, deductibles, coverage limitations, and help you find something that you can afford.



"Do it yourself" insurance probably isn't the best idea for someone with no familiarity with basic terms.
Call a health insurance broker. They'll show you all of the plans and explain everything to you. When you buy from them, the insurance company compensates them, but it doesn't affect what you pay. Plus if you have issues later they can help. Educated consumers always use an insurance broker.
Go through a local insurance agency and they can explain their policy and coverage in detail.