Co-pay plans will still have a deductible (in some cases it will be $0) and out-of-pocket maximum.It’s important to check all details of the plan to get the specifics. Co-pay plans will usually have a co-insurance (the cost sharing with the health insurance company) on higher ticket services, like hospital stays, maternity care, x-rays, etc.You will usually pay a higher monthly premium to get the coverage benefit of co-pays up front. As an example, your plan could have a $20 co-pay for primary care doctors, $40 for specialists, and $15 for generic drugs. A co-pay plan sets fixed dollar amounts (called “co-pays”) that you’re required to pay when you go in for medical services.That means you’re charged the same amount the insurance company would pay rather than the list price for medical care that you would pay if you didn’t have coverage. However, with a HDHP the insurance company negotiates reduced payment rates with medical providers. It may seem like paying “full price” until you meet your deductible isn’t saving you anything out of pocket.

Reimbursements for qualified expenses made from the account are also not taxed. The money you deposit into a health savings account is tax advantaged, meaning that you can deduct contributions that you make to the account on your taxes. This is essentially a savings account where you can put money aside to spend on qualified medical expenses, including deductibles.

If you have a HDHP, you’re often eligible for a health savings account (HSA).

Lower monthly premiums than co-pay plans.

For people who don’t expect medical expenses, these plans may be better. These plans typically have lower monthly premiums.

HDHPs may also make sense for people who don’t go to the doctor often.

These plans tend to work well for people who know they’ll meet their deductible early in the year and who can afford to pay the deductible-sometimes in one lump sum or over the course of a year.

At that point, the insurance company pays 100%, and you’re done paying the co-insurance. You’ll continue to pay co-insurance on the covered expenses that require it until you meet your $4,000 out-of-pocket maximum. You will cover 20% of the covered expense ($20) and your insurance company will cover 80% ($80). You visit the dermatologist (a specialist) and have a $100 bill. When you visit a specialist, you have a 20% co-insurance. For example, let’s say you’ve met your deductible of $2,500 for the year.

After you meet your deductible, you’ll likely have what’s called “co-insurance.” Co-insurance is basically a fancy term for the cost sharing percentage between you and the insurance company.

The out-of-pocket maximum is the most you’ll pay out of pocket for the policy year.

Your deductible is the amount you’ll pay before the health insurance company begins helping you pay for your covered expenses. How much you pay out of pocket depends primarily on two things: your deductible and your out-of-pocket maximum.As you begin shopping for your new plan, it’s likely that you’ll come across the terms “High Deductible Health Plan” and “Co-Pay Plan.” You may be wondering what the differences are between these plans and which is right for your healthcare needs and budget? Here are some key differences to keep in mind as you make your 2018 coverage decisions: 2018 Open Enrollment is here, which means it’s time to evaluate your health insurance options for the coming year.

Deductible vs premium vs copay