How Much Will Your Insurance Cost?

Common Questions About Insurance Costs

This information was adapted from information provided by The Hospital Association of Pennsylvania. You can contact the Association at (570) 564-9200.

Insurance coverage can cost you in several ways. Your company may require you to pay part of the cost of your insurance premium. Usually, you make this payment through payroll deductions--the payments get taken out of your salary before you get your paycheck. You may be insured as an indivudal and pay premiums directly to your insurance provider.

What is your annual contribution?

Many employers and government programs require you to pay part of the annual premium for your insurance coverage. If you are covered through work, check with the benefits manager in the human resources/personnel department at your employer to get this information. As an insured individual, your insurance agent can provide annual costs.

If you are on Medicare, check with your local Social Security office or call your local Area Agency on Aging to get this information.

If you are on Medical Assistance, call your county assistance office or the state Department of Public Welfare to get this information.

Your contribution may be different for each insurance plan available to you. Find out how your contribution is collected. Do you pay it at the beginning of the year or do you pay a small amount every month or every paycheck?

What is the plan's annual deductible?

Some plans may require you to pay costs for care you receive up to a certain dollar level before the insurance will begin to pay. This is called a deductible. For example, if the deductible is listed as $500, you will have to pay for $500 worth of medical expenses each year before the insurance begins to pay for subsequent expenses. Typically, a higher deductible results in a lower annual contribution, (and a lower deductible results in a higher annual contribution) so you will want to make that decision based on your situation.

What are the co-payments?

In addition, you may have to pay each time you see a doctor, fill a prescription, or use other health services. Many health plans require you to make a small payment every time you use a service, fill a prescription, or see a physician. This is called a co-payment.

To most accurately estimate your yearly costs, you should try to estimate how many times you and your family members are likely to visit the doctor, need a prescription filled and use other health services.

Does the plan have a maximum coverage amount?

If you become seriously ill or critically injured and need extensive medical care, does the plan limit how much and for how long it will pay for your care? Many plans will put a limit on the amount they will pay for special needs services, such as rehabilitation care, drug and alcohol treatment, mental healthcare and skilled nursing care.

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