Three Important Facts You Need to Know | Health Insurance Quotes Wisconsin

  • May 03, 2016
  • |Quartz
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All ACA-compliant plans fall into one of five levels – from the lowest premium cost to the highest. These are catastrophic, bronze, silver, gold and platinum. These levels make it easy to compare quotes for similar plans.

While comparing is easy, it’s important to look deeper than the cost of the premium when looking at health insurance quotes in Wisconsin. If you end up in the hospital, how you are charged for health care becomes very important. Below are three things to consider –

  1. Check the “Out-of-Pocket” costs. This is what you pay besides the premium.  These costs are usually made up of the following –

    • Deductible – the amount you pay before your insurance pays anything.
    • Copayments (copays) – the costs you pay when you get health services or prescriptions. These may or may not add up towards your deductible. Most of the time, these costs don’t count toward your deductible.
    • Coinsurance – Your share of the costs of a covered health care service, calculated as a percent. You pay coinsurance plus any deductible you owe.
  2. Check the “Out-of-Pocket-Maximum” – by law, these costs can’t exceed $6,850 for a single person and $13,700 for a family in 2016. Your copays, coinsurance and deductible are included in this amount. However, certain health care services and therapies are not included. These include –

    • Services you receive that are not covered by your plan. This may include certain types of surgery (such as bariatric surgery) and other things like private rooms when hospitalized.
    • Services you get from a provider that is out-of-network. The exception to this is emergency care, which is covered no matter where you are.
    • Certain prescriptions are not covered and won’t count toward your out-of-pocket maximum.
  3. Consider what extra programs are available but not listed on the health insurance quote. For example, wellness programs can provide reimbursements and discounts for things like acupuncture, massages, working out and much more.

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