Understanding Premiums, Deductibles, Copays and Out-of-Pocket Maximums

These terms describe how much you pay out of your paycheck, how much you or your insurance pays for doctor visits and the maximum you will pay per year.

These terms are important to understand so that you know how much your insurance plan is going to cost you. A deductible is a fixed amount of money that you must pay for medical expenses before your insurance coverage kicks in. This does not include the amount that is taken out of your paycheck each month (your premium), so the higher your deductible amount is, the lower your monthly payments. A copay is a fixed amount of money you must pay each time you visit the doctor. The out-of-pocket maximum is the absolute highest amount you’ll have to pay in a year for your medical expenses, in addition to your monthly premium.

[lindsayhengehold]

Great video on this topic, there are coinsurance payments as well.

[ricklynch]

Premiums and deductibles sound like the same thing. I pay $352 a month premium and $3000.00 yearly deductible. So I end up paying $7224 a year. I don't get it. I guess if a person was really in poor health it would make it sound like a good deal. But if y6ou are in poor health you probably are not working in which case you are going to go bankrupt and if you are working you are still going to go bankrupt. I don't get it.

[jasonsims]

You left off deductibles for prescriptions.. it's a mess with bcbs. They give you a plan with 0 deductibles for service but 250 deductible for prescriptions medicine. Trickery.

[MelodicMotives]

Like your video. Very informative. Insurance is part of everybody's life.

[samuelbarrett]

what is the best plan for preexisting conditions?

[babayega]

Is premium specifically taken out of your paycheck or it means any payment one makes individually to keep an insurance cover??!

[carolynwheaton]

Thanks for explaining deductibles.I had to go to the Er .I was told i had blister and put on keflex.i thought my insurance paid the bill.Billing department called said i owe $900 .i asked could i pay $25 a month they said i need to pay $30 even though each pay period they are taking money out my paycheck.

[anthonymmeek]

I think examples in the end would have made this video perfect. Great otherwise

[emmanuelquerol]

So, Copayment alone is not covered by Insurance, so therefore this terminology must be removed because its practically useless.