Other Insurance Plan Details to Think About
There are other insurance plan details that may affect how much you pay. This includes the out-of-pocket maximum and the insurance plan network. The out-of-pocket maximum is the most you will have to pay for your health care for the year. If you have costs above this amount, your insurance plan will pay the entire cost. Also, your insurance company works with certain doctors and other providers. These providers are in your health plan’s network. Your costs will be different if you use a doctor outside of your insurance network. It is always important to make sure the doctor or provider you visit is in-network. This will help you avoid higher medical bills.
- Out-of-pocket maximum - This is the maximum amount you will pay for the year for all your health care. Once you have paid this amount, your health insurance pays the rest of your costs. The out-of-pocket maximum starts over each year.
- Network - This is a group of facilities and providers who your health insurer or plan has contracted with to provide health care services. If you use doctors who are in the network (called in-network), you will pay regular costs. If you see a doctor outside of your network (called out-of-network), you will pay more. The costs you spend for out-of-network services will not count towards your out-of-pocket maximum.