Ahealth insurance premiumis a monthly fee paid to aninsurance company or health planto provide health coverage.
But keep in mind that most health plans are heavily subsidized, as discussed below.
The premium payments have adue date plus a grace period.
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Other health insurance costs may includedeductibles,coinsurance, andcopayments.
Premiums are not considered cost-sharing.
If you don’t need any treatment, you won’t pay a deductible, copays, or coinsurance.
Who Pays the Health Insurance Premium?
They will then cover the rest of the premium.
Eligibility for premium tax credits depends on your income.
But the American Rescue Plan andInflation Reduction Acthaveeliminated that income limit from 2021 through 2025.
And the subsidies are substantial.
But premium tax credits aren’t available if you have access toaffordable, comprehensive coverage from an employer.
Premiums are much more common for CHIP coverage,which tends to have higher income limits than Medicaid.
After much research, you eventually end up selecting a particular plan that costs $400 per month.
That $400 monthly fee is your health insurance premium.
If you are paying your premium on your own, your monthly bill will come directly to you.
In that case, you will not have to pay any monthly fee out of your own pocket.)
This is not a common option, but it’s available and the choice is yours.
Deductibles, Copays, and Coinsurance
Premiums are set fees that must be paid monthly.
If your premiums are up to date, you are insured.
Deductibles, co-payments, and coinsurance are applied toward a patients annualout-of-pocket maximum.
However, premiums must continue to be paid, every month, to maintain coverage.
Premiums are not counted as part of a health plan’s out-of-pocket maximum.
But it’s also important to verify that you’re considering all of the other factors.
Or if it doesn’t include your prescriptions in itsdrug formulary.
Premium is important, but so is the coverage.
Kaiser Family Foundation.2022 Employer Health Benefits Survey.
October 31, 2022.
Kaiser Family Foundation.Premiums and Enrollment Fees for Children.
Internal Revenue Service.Form 8962.
