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FAQ

Frequently Asked Questions

How do Copays, Deductibles & Coinsurance Work
Penalties of Individual Mandate
Premiums
Subsidies/Calculator
What is Health Insurance
Doctors, Hospitals & Facilities

What is Health Insurance?

Health insurance is a contract between you and your insurance company. You buy a plan or policy, and the company agrees to pay part of your medical expenses when you get sick or hurt. Health insurance provides you access to preventive care to keep you healthy, like vaccines, routine physicals and check-ups. Many plans also cover prescription drugs.

Health insurance helps you pay for care

Did you know the average cost of a 3-day hospital stay is $30,000? Or that fixing a broken leg can cost up to $7,500? Having health insurance can help protect you from unexpected costs like these. Your insurance policy will show what types of care, treatments and services are covered, including how much the insurance company will pay for different treatments in different situations.

What will I pay for health insurance?

The cost will be determined by the plan you choose, your age, where you live and if you smoke or not. You’ll usually pay a premium every month for health insurance, and you may also have to meet a deductible once each year before the insurance company starts to pay its share. How much you pay for your premium and deductible is based on the type of insurance you have.

The premium cost is how much you have to pay when you get services. Examples include:

  • How much you pay before your insurance coverage starts (a deductible)
  • What you pay out-of-pocket for services after you pay the deductible (coinsurance or copayments)
  • How much in total you’ll have to pay if you get sick (the out-of-pocket maximum)

What your policy covers is often directly related to how expensive the health insurance policy is. The policy with the cheapest premium will generally not cover as many services and treatments or have lower out of pocket expenses.