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What’s the Difference Between a Premium, Deductible, Copay, and Coinsurance?

The health insurance that’s provided by Medicare was created to save beneficiaries money.  While Medicare can significantly reduce medical bills, there are some out-of-pocket costs that beneficiaries will need to cover on their own.  

Understanding the costs of Medicare is important when making plans for the future and thinking about retirement.  Having health insurance is important, so let’s go over what some of these costs are and how they could impact you financially.

Premiums

Medicare premiums are paid monthly and can range depending on your policy.  Medicare premiums are the cost that’s required to keep your policy active and ensure that you have access to your health insurance.  Paying your premiums on time is incredibly important, as failing to do so could result in loss of coverage.

Some Medicare Advantage policies do not have premiums.  This will depend on the specific policy that’s selected and is a good thing to ask about while you’re enrolling.  

Paying Medicare taxes is important during your career.  If you do so, then you’ll receive Part A premium-free.  This is a feature that makes Original Medicare very affordable.

Deductibles

Deductibles are the amount that must be covered out-of-pocket before your policy’s coverage begins and are per insurance period.  How much a deductible is will depend on the specific policy, but they can range significantly.  Meeting your deductible early in the year will most likely mean that you’ll save more money on any additional health care that you need.

Copayment

Copayments are the amount that a beneficiary must pay for certain things.  Many policies will include copayments whether or not the beneficiary has reached their deductible.  Copayments typically come in a flat fee, so that beneficiaries can know exactly how much they’ll need to pay for a service and are able to plan accordingly.

Coinsurance

Coinsurance is the percentage of costs that a beneficiary must pay after they’ve reached their deductible.  This is especially vital when discussing Part D, as the various tiers are organized in order of increasing coinsurance.  Understanding the coinsurance guidelines of your policy is incredibly important, as it can give you an accurate idea of how much you will need to pay.

Planning for the costs of Medicare

If you’re beginning to think about your health insurance situation during retirement, know that we’re here to help in that process.  Thinking about the costs of Medicare may be overwhelming, but keep in mind that it’s intended to save money and many beneficiaries find that they have increased access to care with lower bills.  

If you want to learn more about Medicare, contact us today and let us provide you with more information.  We’re here to give support and answers to the pressing questions that you have.  Everyone deserves to have answers to their questions, so we ensure that our clients make decisions based on facts and a detailed knowledge of Medicare.

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