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Published on October 20, 2020

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How Health Insurance Works

Do terms like co-pay and high deductible health plan make your head spin? Or maybe you don’t know whether you should get a lower premium or lower out-of-pocket plan?

Health insurance is an essential investment for your long-term health. But there’s a lot to consider when you’re trying to find the best plan for your needs and budget.

Here’s one thing to consider: look beyond the monthly premium to figure out the best value for you and your family.

  1. Consider the deductible. Your deductible will tell you how much you’ll have to pay before your coverage (coinsurance) kicks in. Lower premium plans often have higher deductibles. Here’s a good rule of thumb: Higher premium + lower deductible = lower out-pocket costs for high-cost issues (think pregnancy).
  2. Know what comes for free. Some plans offer $0 co-pays for certain types of clinic visits such as primary care, urgent care or even chiropractic visits. Remember, most preventive care (your yearly wellness visit or cancer screenings) is covered at no cost already. Virtual care may also be no-cost benefit.
  3. Take advantage of incentives. You also get value-added benefits with your insurance coverage that may save you money here and there. Think fitness center discounts, well-being programs, health coaching or care management programs (help if you have a chronic condition or serious injury).

The Avera Health Plans team knows a lot about health insurance – it’s what we do. So, we’re sharing the love. Here’s everything you need to know in one spot.

How Insurance Works

Co-pays, deductibles and coinsurance are confusing. Learn when you pay for services and when your insurance pays.

Once you switch to a family plan your deductible changes, too. Learn why you still pay toward an individual deductible with a family plan.

Learn how qualifying life events allow you a special enrollment period beyond open enrollment.

How to Make the Most of Benefits

How to Choose a Plan

Need details on plan types? This guide tells you all you need to know about health insurance.

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Avera is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values.

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