Balancing Health Insurance Costs
When it is time to purchase health insurance for you and your family, finding the best plan — that also fits your budget — means understanding how to balance cost with coverage. Securing affordable health insurance can begin with insight into how your health care costs are covered.
Know your monthly premium and more
Health insurance includes five different types of costs. While reviewing plans, knowing what these terms mean makes it easier to select a plan that fits your finances.
- Premium - what you pay monthly for your plan
- Deductible - what you pay before the plan pays
- Copay - what you pay with every visit to a health care provider
- Coinsurance - the percentage of costs you pay after you meet your deductible
- Member out-of-pocket maximum - the most you will pay annually for coverage
Estimate your annual health insurance costs
While you may not be able to predict every health care cost in a year, you can estimate what you will pay annually by reviewing your current health care needs. Just ask yourself a few questions.
Q: Are annual checkups usually the only time that you and your family visit the doctor?
A: If so, take a look at plans with a low monthly premium and a higher deductible. You pay less for health insurance monthly, but may pay more when you need more care other than a doctor visit.
Q: Do you or members of your family see doctors frequently and take prescription medicine regularly?
A: If your answer is yes, review health insurance plans with higher monthly premiums, but lower deductibles. You pay more monthly but pay less for health insurance coverage you use all the time.
Q: Do you qualify for a health insurance subsidy?
A: The Affordable Care Act (ACA) can help reduce annual coverage costs and you can save if you qualify.
Health insurance subsidies
are based on your earnings and family size (including yourself, your spouse, if married, and anyone you will claim as a tax dependent — even if they do not need coverage). Subsidies also consider the cost of health coverage in your state.
Compare costs with the ACA
Comparing costs with ACA health insurance plans is easy because of how they are organized. You can compare plans in four categories: Bronze, Silver, Gold, or Platinum. The plans differ only in how you and your insurance provider share the overall cost.
| Plan | Bronze | Silver | Gold | Platinum |
|---|---|---|---|---|
| What your plan pays | 60% | 70% | 80% | 90% |
| Your cost | 40% | 30% | 20% | 10% |
| Plan | Bonze |
|---|---|
| What your plan pays | 60% |
| Your cost | 40% |
| Plan | Silver |
| What your plan pays | 70% |
| Your cost | 30% |
| Plan | Gold |
| What your plan pays | 80% |
| Your cost | 20% |
| Plan | Platinum |
| What your plan pays | 90% |
| Your cost | 10% |
No matter what plan you choose, your monthly premium is based on your earnings, so actual health insurance rates will vary. Learn more about ACA open enrollment for health insurance for individuals and families so you know when to apply.
How does coverage compare to cost with the four ACA plans?
Bronze plan
Cost: Lowest monthly premium, but highest deductible.
Coverage: A Bronze plan is your best choice when you do not visit your doctor beyond preventive care visits, but want peace-of-mind protection for medical emergencies.
Silver plan
Cost: A slightly higher monthly premium, but a lower deductible than a Bronze plan.
Coverage: If you qualify, you can save even more with the Silver plan, including an Advanced Premium Tax Credit and Cost-Sharing Reductions.
Gold plan
Cost: Higher monthly premium, but lower deductible.
Coverage: Gold is the best plan if you require a lot of health care because almost all of your routine medical care costs are covered.
Platinum plan
Cost: Highest monthly premium and the lowest deductible.
Coverage: Platinum is the preferred plan when you rely on regular routine medical care and want the most coverage.
Find the affordable coverage you need
We are committed to helping you on your health care journey. While calculating your cost, you still may need some help. Anthem is here to guide you as you choose a health insurance plan. We can tailor a plan that fits your coverage needs and your budget, too.
