You’ve just gotten injured. The last thing on your mind is how much you’re going to have to pay for treatment.
Until you get the bill.
There are many options out there for health insurance coverage. The challenge is that most people don’t read the fine print. You could think that you have the best coverage money can buy, only to find out not much is covered in the event of something major.
It’s important that people do their research. Today we’re going to help with that. We’re going to go over 80/20 health insurance and five important things you need to know about 80/20 plans.
1. What is 80/20 Health Insurance?
Firstly, 80/20 health insurance is a particular type of health plan based around the co-insurance or “co-pay” a patient is required to pay. The idea in an 80/20 plan is that your healthcare provider will cover 80 percent of your medical costs, while you are responsible for the other 20 percent.
Secondly, Most health insurance plans, including 80/20 plans, also have what’s known as an out-of-pocket limit. This is important to look at when you’re purchasing a health insurance policy. The out-of-pocket limit represents the most money you can pay for medical care within a calendar year.
In the case of an 80/20 plan, you will pay 20 percent of your health bills until your out-of-pocket limit is reached. At that point, you would be done paying for the year and your out-of-pocket limit would reset at the start of the following year.
2. What Does An 80/20 Plan Cost?
Like most health insurance plans, a lot of the features are customizable. The general “rule of thumb” in health insurance is: the lower your deductible is, and the lower your co-pay is, the higher your monthly premiums will be.
For that reason, an 80/20 plan may be towards the high end of monthly premiums you can expect to pay. The good news, though, is that you can work with a health insurance agent to adjust your plan.
If you decide you can shoulder a little more up-front cost on your medical bills, it may make sense for you to switch to a 70/30 or 50/50 plan to save on monthly premium costs.
Again, it’s also important to ask “what is my total out-of-pocket limit” on any of these plans. If you are torn between two different plans for you and your family, the out-of-pocket maximum could make the difference.
3. Covered Services
It’s important to note that the 80/20, 70/30, or 50/50 split we’ve discussed in this article only applies to covered services. When you are researching a health insurance plan, the marketing materials will typically have a schedule of services for each plan. This schedule of services outlines which doctors you can go to, what procedures you can have done, and what medications you can order under that particular plan.
It’s always a good idea to double-check and make sure the procedure, doctor, or medication you are dealing with is covered under your plan. Medical expenses can be pricey enough as it is. No one wants to get hit with a surprise bill they didn’t see coming!
A Clean Bill of Health
You’re all done! Now you can pass your “check-up” on what 80/20 health insurance is. We hope we gave you some valuable information, and valuable questions to ask an agent when choosing what plan is right for you.
We’ve covered what an 80/20 plan is, what to know about co-insurance, how to be careful of your out-of-pocket maximum, how to adjust your coverage-to-co-insurance ratio to create some cost savings, and we’ve also talked about knowing your schedule of services.
We hope these five important facts about 80/20 plans helped you to make the best decision for you and your family.
What other health insurance questions do you have? Let us know in the comments and we’d love to help!