Copay: Copays are types of cost sharing payments you may have to make out-of-pocket when you receive certain health care services or medications. They’re typically a flat rate; for example, $10 per doctor’s visit or $15 for certain medications.
Coinsurance: Coinsurances are another type of cost sharing payment you may have to make out-of-pocket when receiving certain health care services or Medications. These are usually in the form of a percentage. For instance, let’s say you have a 10% coinsurance for a doctor’s visit that costs $100. You will pay $10 for every $100 your insurance pays for a doctor’s visit.
Out-of-pocket maximum: This is a cap on how much you’ll have to pay out of pocket for health care in one year. After you reach this amount your insurer will pay for your covered care in full for the rest of the year. For example, if you have a $44,000 out-of-pocket limit and you’ve met your $4,000 deductible and paid $40,000 in other cost-sharing payments (like copays or coinsurances), you’ve met your limit and your insurance company will pay for any covered care for the rest of the year. Affordable Care Act compliant plans require all major medical health insurance plans to have an annual out-of-pocket maximum for each beneficiary.
Every health insurance plan is categorized by different metal ratings based on how much coverage they offer. There are 5 levels of coverage you can get with an ACA plan:
Bronze: You can expect to pay 40% of the costs for covered care with your plan paying 60%, these plans have the highest out-of-pocket costs with the lowest premiums.
Silver: You can expect to pay 30% of the costs for covered care with your plan paying 70%, these plans have high out-of-pocket costs with low premiums.
Gold: You can expect to pay 20% of the costs for covered care with your plan paying 80%, these plans have low out-of-pocket costs with high premiums.
Platinum: You can expect to pay 10% of the costs for covered care with your plan paying 90%, these plans have the lowest out-of-pocket costs with the highest premiums.
Catastrophic coverage: In addition to the 4 metallic levels of coverage, you may have the choice to get a plan with catastrophic coverage. Catastrophic coverage is a type of coverage available to those under 30 or those who qualify for a “hardship exemption”. They are designed to protect you in a worst-case scenario, hence the name “catastrophic” coverage. These plans have very high-deductibles and low premiums.
The cost for health insurance plans varies greatly depending on the type of plan and level of coverage. Even if you stay with the same health insurance plan year after year, you can expect the cost of your plan to change yearly.
According to a recent study by eHealth, the average health insurance premium is $484 for individuals and $1,230 for families. However, actual prices available depend on zip code, age, gender, and other factors. Browse health insurance by state to find plans and see pricing in your area.
It’s also important to consider more than your monthly payments when choosing a plan. Even if you choose a plan with a lower premium, you may end up with a higher deductible, which could lead to you having to foot large medical bills before your insurance kicks in.
Be sure to not only consider your budget but your past and present health needs. You may find you will save money with a plan that has a higher monthly premium and lower deductible if you’re someone who needs frequent hospital or doctor’s visits.
If you are unsure what plan is best for your needs and your budget, one of eHealth’s licensed health insurance agents can help you make the right decision. You can check out our other resource center content on health insurance costs as well.
Depending on the type of health insurance you are looking for and other relevant circumstances in your life, you may be able to buy health insurance at any point in the year, or you may have to wait until the Open Enrollment Period, which is the annual period when you can enroll in ACA major medical health insurance plans. Open enrollment periods may vary by state, so check out the full list of Open Enrollment Periods by state to see when you’ll be able to find an ACA plan.
That being said, if you experienced a qualifying life event (loss of employer-sponsored health insurance, divorce, relocation to a new coverage area, etc.) you may be eligible for a Special Enrollment Period, which would allow you to sign up for an ACA plan outside of OEP.
Additionally, Medicare has a separate Annual Election Period, and many other types of insurance plans, like short term health insurance plans, can be purchased year round. If you have specific questions on when you can sign up for specific health insurance plans, the eHealth team can help you figure out when you can purchase the right plan for you.
There are a few places where you can buy health insurance. You can go through your state or the federal marketplace or through an insurer.
You can also shop with eHealth, the first and largest independent online health insurance marketplace. Choose from over 10,000 plans from over 180 insurance companies. We’re unbiased and we’re here to help you find the right plan for you, your family, or your small business.
Bharat Sookshma Udyam SurakshaFind ACA coverage or fill a coverage gap with a short-term insurance plan from our selection of over 3,600 plans from over 16 carriers.
Once you’ve found the right plan, let eHealth be your health insurance advocate. Our customer support team is willing and able to answer any questions you may have about your plan’s coverage, billing, or any other tricky aspects of health insurance.
We’re here for you around the clock! With our online chat function, email, and phone support we’re available 24/7.
We’re committed to helping make health insurance affordable and easy. We’ve done it for over 5 million customers, let us help you too!
Insurance isn’t the most exciting facet of car ownership, but it’s one of the most important. Your policy is designed to protect you from financial calamity in the event of a collision or related injury, and insurance coverage is required by most states if you want to register a car. Consumer Reports recommends shopping around for the best policy, not only when you buy a car but also every few years, to make sure you’re always getting the best deal possible.
Through a survey of more than 40,000 members, CR has identified the insurance companies that offer the best service with the most competitive monthly premiums. To get the best car insurance rates, it helps to understand what attributes insurers consider when they formulate your monthly premiums. They include the following factors.
Driver profile: Age, driving experience, and driver history—for example, if you’ve had crashes or traffic violations—can all influence the cost of your premium because the insurer may put you in a higher risk category. The addition of a teen driver can also raise the cost of your policy.
Driver profile: Age, driving experience, and driver history—for example, if you’ve had crashes or traffic violations—can all influence the cost of your premium because the insurer may put you in a higher risk category. The addition of a teen driver can also raise the cost of your policy.
Car type: In general, the more expensive the car, the higher the premium because expensive cars cost more to repair and replace. High-performance cars also cost more to insure because of the increased risk associated with owning a faster car.
Credit history: According to Experian, a credit reporting agency, most states allow insurers to factor a customer’s credit score into their rates. Insurers maintain that credit history is a good predictor of the risk that they’ll have to shell out for insurance claims. California, Hawaii, Maryland, Massachusetts, Michigan, Oregon, and Utah restrict or prohibit the practice. In other states, improving your credit score can help you get a better rate.
External conditions: Local weather patterns, traffic conditions, and other factors that increase the likelihood of claims result in higher rates. For example, if damaging storms in your area have generated lots of car-insurance claims in the past, such as major hurricanes and flooding, your company may apply to your state’s insurance regulator for an across-the-board rate increase to reflect its increased exposure to that risk. Customers in areas with higher rates of collisions are also likely to pay more.
It is a common misconception that insurers reward customers for sticking around. A recent national survey commissioned by CR shows that you can save money by shopping around for a better rate from time to time. Twenty-eight percent of the members we surveyed told us they’d switched insurers in the past six years. Among those, 58 percent said they’d found a better price, and 37 percent said they switched because of premium increases from their previous insurer.
“Price optimization” can be another reason to shop for a new insurer every few years. So far, 20 states have outlawed this controversial practice, which allows insurers to raise rates for reasons that aren’t related to increased liability risk. Here’s how it works: If an insurer figures you aren’t likely to jump ship to another carrier, it may raise rates just because it can, costing you extra money.
If you get married, add a teen driver to your policy, or add or remove a vehicle, or the distance of your commute changes—as it did for many people during the pandemic—ask your insurer how much the changes will cost or save you. Shop other insurance companies to see which carrier can give you the best rate. Remember to ask for an adjustment to your coverage to reflect your car’s depreciation; insurers don’t necessarily do that without your prodding.
For a comprehensive list of insurers that might not be visible with a simple Google search, consult CR’s car insurance ratings.
Securing a lower premium is important, but price isn’t everything. Find a carrier that—in addition to having competitively low premiums—provides fair and fast claim settlements, offers great customer service outside of claims, helps you review your policy thoroughly, and proactively offers help and advice.
CR rates insurers based on member feedback on the cost of their premiums, the ease of processing claims, the quality of non-claim-related customer service, thoroughness of policy review, clarity of policy coverage, and proactive help and advice. To create our ratings, we surveyed 40,251 CR members in the summer of 2022 about their car insurance. They provided us with 47,713 reports on their experiences with the car insurance companies they did business with, and told us whether they had switched insurers or filed a claim between 2018 and 2022. (CR members’ experiences are not necessarily representative of the U.S. population.)