Understanding health care costs and choosing the right plan

Open enrollment is here once again, and it’s time to think about your health coverage for 2019. It is important to understand your options so you can select coverage that best fits your needs. We have a few tips and terms that will make it easier to evaluate your options and the Kaiser Permanente Member services team is ready to help you.

Most people don’t hear words like “premium” and “deductible” every day. Here are the definitions:

  • Deductible: An amount you pay for covered services each year before your plan starts paying. (Not all plans have deductibles.) For example: Your plan has a $500 deductible. You pay the full charges for covered services up to $500. After you reach this amount you pay just a copay or coinsurance for each visit.
  • Copay: The set amount you pay for covered visits.
  • Premium: The monthly fee you pay for your health plan.
  • Coinsurance: A percentage of the charges that you pay for covered services. For example: If a procedure is $200 and your coinsurance is 20%, you pay just $40. Kaiser Permanente covers the rest ($160).
  • Out-of-pocket maximums: This is the most you’ll pay for covered services each year. If you reach this maximum, you won’t pay out-of-pocket costs for covered services for the rest of the year.

Tip: If you’re a current Kaiser Permanente member, sign in to your online account at kp.org/wa to see your medical expenses for 2018. While you can’t plan for every medical need, consider what you do have planned or might expect for the coming year. Will you need more or less coverage than previous years?

Reminder: Individual and family plan open enrollment starts November 1, and the enrollment deadline is December 15 for coverage starting January 1. The Medicare Advantage plan annual enrollment period began October 15, and the deadline to enroll is December 7.

You can find more tips on choosing the right plan here, and if you’re a current Kaiser Permanente member, our Member Services team is available to answer any questions you may have.

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