Your total costs for health care: Premium, deductible & out-of-pocket costs
When picking a Marketplace health plan, it's important to compare your estimated total yearly costs for each plan - not just the premium. The costs when you get care can have a big impact on your budget. Total yearly costs include:
- Monthly premiumx 12 months: The amount you pay to your plan each month to have health insurance.
- Deductibles: How much you'll spend for certain covered health services and prescription drugs before your plan pays anything, except free preventive services. (For example, your plan may charge for an office visit, but you won't pay extra for the preventive service that's part of that visit.)
- Copayments and coinsurance: The amounts you pay your health care provider each time you get care, like $20 for a doctor visit or 30% of hospital charges.
- Out-of-pocket maximum: The most you'll spend for covered services in a year. After you reach this amount, the insurance company pays 100% for covered services.
Compare estimated total costs for plans
To find a plan that meets your needs and budget, consider:
Your health care needs when shopping for coverage
Determine the types and amount of health services and prescription drugs your household will likely use for the year. Deductibles, copayments, and coinsurance can add a lot to your total yearly costs - sometimes more than a plan's premium.
When you compare plans, you can get a more accurate estimate of your total yearly costs for each plan, based on the level of care you think your household will use for the year. To preview plans and prices:
- Select"Add yearly cost"on any of the plans listed.
- Pick the level of care you expect to use this year— low, medium, or high.
- Select"Save and continue"to get yourestimated total yearly costsfor each plan listed.
Your actual costs will vary based on the services you use. This estimate can help you compare each plan's total impact on your household budget.
Compare plans marked with "easy pricing"
These plans:
- Have the same out-of-pocket costs and care before deductibles for some services.
