NC Health Insurance - Which Plan is Best
NC health insurance comes in different flavors. There are group plans offered by employers. There are individual plans offered by private insurance companies to individuals. There are plans designed around the co-pay, low deductible model. There are plans designed around the Health Savings Account (HSA) and high deductible model. You may be familiar with the difference between group and individual plans. But, here are some of the differences between the co-pay and the HSA plans.
What is a co-pay plan? Co-pay plans work under the model of paying a set amount each time you visit the doctor or get a prescription filled. These plans come with different deductible and co-insurance options that kick in with any medical expenses outside of doctor visits and prescriptions. What is an HSA plan? This type of plan has two parts. The first is a health insurance plan that has no co-pays, but does have a high deductible. The second part of the plan is an HSA linked to the high deductible health plan. The patient pays the entire deductible before health insurance kicks in. That includes the expenses for doctor visits and prescriptions. NC health insurance comes in both varieties.
What are the differences in co-pay vs. HSA? One of the largest differences is cost. Premiums for a typical family are often 20-40% less for an HSA plan than for a co-pay plan. HSAs are tax-deferred. That means all money you put into the account comes off the amount you pay for taxes. Once you meet the deductible, with an HSA plan, insurance covers all medical expenses. The deductible amount in a co-pay plan is for each person (up to a family maximum). So, if a co-pay plan has a $2,500 deductible, it applies to each person of the family. So, for a four-person family, that equals up to $5,000-$7,500 in deductibles depending on the carrier you have. The same family, under an HSA plan, may have a $5,000 deductible that covers the entire family.
In addition to the deductible, most NC health insurance copay plans also have coinsurance. This is the percentage that the carrier will cover once the deductible is met. This will greatly increase your out of pocket exposure with these plans that you need to be aware of. With HSA plans, typically once the family deductible is met the carrier will cover 100% of the healthcare expenses for the rest of the calendar year.
Are there any differences in care? Actually, there is none. You get the same medical care, no matter which plan you have. However, you will find that your premiums will usually be lower with an HSA plan which often time offsets not having copays for doctor visits or prescription drugs. Each family and individual will be different. You and your neighbor may come out with different premiums based on your individual circumstances. The best way to tell what the best plan is for you is to speak with a NC health insurance specialist and get an idea of costs each way.
