Before looking at Anthem health coverage levels, it is helpful to have a basic understanding of health insurance terminology. Hearing the terms “copay,” “deductible,” and “premiums” can be confusing to people who have never been insured — and they are sometimes even confusing to people who have been covered by health care plans for years! What do people mean when they use these terms?
A copay is the term health insurance companies like Anthem use to refer to the payment that individuals are responsible for when they get services from a health care provider. Going to an urgent care, for instance, might cost a patient up to $100. This is not the actual full cost of the medical services. The insurance company pays for the majority of the cost, while leaving the copay to the patient. The size of a patient’s copay depends upon their level of coverage. However, the average copay the most United States citizens pay is between $15 and $25.
A deductible refers to the amount of money that a patient must spend before their insurance kicks in. If an insurance plan has a $1000 deductible, this means that the health insurance company will not pay for any medical services until this number has been exceeded. Anything less than the deductible must be paid for out of pocket. The dollar amount of a person’s deductible depends upon their level of coverage.
In general, people who pay higher premiums have lower deductibles and copays. A premium refers to the amount of money a patient spends each month to pay for their insurance coverage. While some plans may be quite affordable due to low monthly premiums, the cost can add up when it comes to paying high copays and having to handle out of pocket expenses until the deductible is exceeded. Just because a plan has a high premium, does not mean it is a more expensive plan — since people who need frequent medical treatment can actually end up saving money.