High-deductible, or HSA-compatible plans
A Health Savings Account (HSA) helps you set aside money for medical expenses. High-deductible plans are set up to help you make the most of an HSA. Here's how they work:
- Use the money in your HSA to make tax-free payments for approved medical and dental costs.
- You pay 100 percent of costs until you've met your deductible. One important exception: Your plan pays for all preventive care.
- You'll have some costs after you meet your deductible. Co-insurance may apply. This means you pay percentage of costs.
- You'll have an out-of-pocket limit. Once you've reached this limit in payments, the plan will pay 100 percent of costs.
Co-insurance-only plans
Co-insurance-only plans are similar to HSA-compatible plans, but with one key difference. You can't pair them with an HSA because they don't meet the cost-sharing requirements set for high-deductible plans. Here's how they work:
- You pay 100 percent of costs until you've met your deductible. One important exception: Your plan pays for all preventive care.
- You'll have co-insurance costs after you've met your deductible. This means you pay percentage of costs.
- You'll have an out-of-pocket limit. Once you've reached this limit in payments, the plan will pay 100 percent of costs.
Copay plans
In this type of plan, you'll pay copay, or a flat fee, for some services. Here's how a copay plan works:- Your policy spells out which services have copays and which don't.
- You pay 100 percent of costs for services without a copay until you've met your deductible. One important exception: Your plan pays for all preventive care.
- You'll have some costs after you meet your deductible. Copays and co-insurance may apply. Co-insurance means you pay a percentage of costs.
- You'll have an out-of-pocket limit. Once you've reached this limit in payments, the plan will pay 100 percent of costs.
- You can't use an HSA to pay costs.
Catastrophic plans
These plans have low premiums but high deductibles. They protect you from the costs of a major illness or injury. Here's how they work:- You pay a copay for the first three primary care office visits.
- You pay 100 percent of costs for other services until you've met your deductible. One important exception: Your plan pays for all preventive care.
- To buy a catastrophic plan, you must be under age 30. You may get an exemption from the health insurance marketplace that serves your state. Find more on hardship exemptions at HealthCare.gov.
- You can't use an HSA to pay costs.
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