Health Insurance Guide For The Self-Employed

1) Copay. A small amount that you pay that is set in your plan for things like office visits and medications.

2) Deductible. Just like your auto insurance, if you hit another car you pay your $500 or $1,000 deductible. Health insurance has the same thing. This is the amount you pay up front before the insurance kicks in. Be sure to never pay your deductible at the time of service! Let them know you need to see what your explanation of benefit shows you are responsible for. MANY people pay more than they should because they pay at the time of service.

3) Coinsurance. This is the percentage that you and the insurance company split after the deductible. It is typically 20 to 30% that you are responsible for until you meet your out-of-pocket maximum.

4) Out-of-pocket maximum. This is the amount you pay if everything goes horribly wrong. Everything you do that is covered under your plan goes toward this number (if it’s an ACA-qualified plan) so your medications, hospital stays, even visits to the Dr. add up. Make sure this is a number you a comfortable with paying in one year!

5) Premium: The amount you pay the insurance company each month to ensure you have insurance coverage.

6) HSA: Health Savings Account. This is the tax-protected savings account that must be paired with a qualified high deductible health plan.