Answers to Questions You May Have
General Questions About Health Insurance
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General Questions about Health Insurance
The amount of money you must pay in covered expenses over 1 year. After you pay your deductible, your plan or program will start paying for certain covered expenses.
Example: If you are in a plan that has a $1,000 deductible, you must spend a total of $1,000 on your health care within 1 year before your plan or program will start paying for your health services. Your deductible resets once every year.
Coinsurance is a fee you owe a doctor for your care. The amount you owe is part (a percentage) of the cost of your care. Your insurance company pays the rest.
A copayment (or "copay") is a fee that you owe a doctor for certain services. The fee is always the same amount of money for the service.
Example: You are getting a normal checkup from your Primary Doctor (PCP). If your plan or program has a $20 PCP copayment, you must pay $20 for that visit. Healthfirst will pay the rest.
The amount of money you must pay monthly, quarterly, or twice a year to be covered by a health insurance plan or program.
The premium is based on:
- How many people will be insured;
- Your household’s monthly gross (before taxes) income;
- Your health information and history;
- The cost of health care in your area.