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What Is Cost Sharing In Health Insurance?
The concept of cost sharing in health insurance is relatively new and has only recently been made available to most consumers. In the past, cost sharing meant that you would pay a fixed amount of money out of your own pocket before the insurance company would pay anything. While this certainly is a convenient way to pay for your health insurance premiums, it does not address one of the major reasons most people do not have insurance: the high cost of premiums. Cost sharing in health insurance works like this:
Most health insurance policies deduct a portion of your premium from your check each month. This is the "cost of insurance" for you. The insurance company then takes that same portion and covers the remainder of your cost of your premium in what is called a cost sharing component.
The reason that the insurance company gives you a share of the cost of your premiums makes cost sharing in health insurance a pretty attractive deal. You are able to pay a lower premium for your health coverage without coughing up a huge chunk of your income. Many people fall into the trap of paying too much for insurance. When you are talking about thousands of dollars worth of savings, is it really worth it to pay that much out of pocket each month?
There are two main ways that cost sharing works in health insurance. There is direct cost sharing, which is the most common form. With direct cost sharing, the insurance company pays a portion of your premiums. They pass the savings along to the individual health plan buyer. For example, if an individual buys a health insurance policy that has a $500 monthly premium, and then he pays for his own doctor visit, dental visits, and prescription medications, he will effectively be paying for a third of his entire monthly health insurance premium.
The other way that cost sharing works is cost matching. Under cost matching, the insurance company will pay a portion of the cost of your monthly premium. If you buy health insurance that is identical to one of their own policies, they will give you a share of the cost of that policy. For example, if a man purchases a policy that covers annual physicals, mental health, and vision care at the same rate as his wife's policy, his wife will be covered for her annual physicals, mental health, and vision care, at the same cost that he is covered for his premiums.
So, how does all of this affect you and your family? It can be a good deal for your pocketbook. But what is also important to understand is that what is cost sharing in health insurance does not mean that you are going to get poor health care. It simply means that you are going to be paying a smaller percentage of your premium for the insurance company to cover the entire cost of your monthly premium. This allows you to save money, depending on what kind of coverage you need for your family.
For car insurance , let's say that you have two children that are in daycare. You would like to have coverage so that you can take them to the daycare for the day, but you do not want to pay for any coverage so that you can get sick and miss work. In this case, you are going to do a little bit of research and find out exactly what it costs for the company to provide coverage for an adult without any health conditions. You will then figure out your budget and figure out how much you can afford to spend on the coverage for both children, assuming no one is already covered for any health issues. Then you would simply add up the monthly premiums for both children and find out what your total cost will be.
What is cost sharing in health insurance is an important factor in determining what kind of health insurance policy is best for you. However, you will still have to closely examine what is included in each policy you are considering. You need to know what the deductible is for each treatment you receive, for example, and what your co-payment is for doctor visits. Once you understand these aspects of your new health insurance policy, you will be able to make a more informed decision about what is best for you.
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