These plans typically have lower monthly premiums. HDHPs may also make sense for people who don’t go to the doctor often.These plans tend to work well for people who know they’ll meet their deductible early in the year and who can afford to pay the deductible-sometimes in one lump sum-over the course of a year.At that point, the insurance company pays 100%, and you’re done paying the co-insurance. You’ll continue to pay co-insurance on the covered expenses that require it until you meet your $4,000 out-of-pocket maximum. You will cover 20% of the covered expense ($20) and your insurance company will cover 80% ($80). You visit the dermatologist (a specialist) and have a $100 bill. When you visit a specialist, you have a 20% co-insurance. For example, let’s say you’ve met your deductible of $2,500 for the year. After you meet your deductible, you’ll likely have what’s called a “co-insurance.” A co-insurance is basically a fancy term for the cost sharing percentage between you and the insurance company.The out-of-pocket maximum is the most you’ll pay out of pocket for the policy year. Your deductible is the amount you’ll pay before the health insurance company begins helping you pay for your covered expenses. How much you pay out of pocket depends primarily on two things: your deductible and your out-of-pocket maximum.

Here are some key differentiators to keep in mind as you make your coverage decisions. My answer is always that it depends on your unique healthcare needs and your personal budget. It requires you to think about what you want and need in a plan, and how much your budget is. One of the most common questions I get is, “Which is better: a high deductible health plan or a co-pay plan?” The answer isn’t that simple. This week we sat down with head of the advisor team, Emily Joyce, to discuss a frequently asked question: what’s the difference between a high deductible health plan and a co-pay plan, and why does it matter?Īs a Gravie advisor, I field a lot of questions about different types of health insurance plans.

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