Making Sense of Your Insurance Quote

December 10, 2013

Although the Affordable Care Act (ACA) doesn’t actually go into effect until Jan. 1, 2014, online insurance exchanges opened on Oct.  1. These “marketplaces” allow consumers to purchase health insurance to comply with the new regulations.

When comparing plans, you might have received a health insurance quote. Knowing how to read this quote and what information to look for can save you plenty of time (and money) down the line.

What Is an Insurance Quote?

An insurance quote is simply a health insurance company’s way of presenting information. Your quote should tell you which services are covered and what your monthly premium will be, and give you an idea of how much your plan will cost over time.

Insurance Quote Lingo

Insurance quotes aren’t exactly known for being straightforward and easy to read. Deciphering the language used can make things easier.

  • Premium – A premium is the amount of money your insurance plan will cost you each month. This premium is paid directly to the insurer and is due whether or not you use any services in the month.

  • Deductible  This is the amount you’ll pay to healthcare providers before services are covered. In California, platinum and gold plans have no deductible; silver and bronze plans have $2,000 and $5,000 deductibles, respectively.

  • Co-pay A set fee you’ll pay for certain services. ($50 per doctor’s visit, $25 per prescription, etc.)

  • Co-insurance The percentage of your healthcare that your insurer will pay after your deductible is met.

  • Out-of-Pocket Maximum The maximum amount you’ll pay in a calendar year for your healthcare. (Under the ACA, this is a set $6350 for individuals and $12,700 for families.)

If you’re unclear about any of this or other terms, ask the issuing company for more information or contact us for help.

Covered Services

The ACA mandates that certain services be covered by all plans. Your quote may list additional services that are covered (or denied). Remember, no one can be denied coverage for a pre-existing condition.

Covered California Insurance Quotes

A visit to the online health insurance marketplace can be overwhelming, but by breaking it down into stages, it’s easily navigated.

You’ll be presented with many different options in four different tier levels: platinum, gold, silver and bronze. Each plan will contain the company’s name, tier level and total monthly premium. Clicking on the “more information” link will shed more light on the plan and give you facts about cost details, standard benefits and a list of deductibles and co-pays for a variety of covered services. To find out more, visit our full guide to Covered California.

In addition, your quote may account for any tax incentives or government subsidies for which you qualify. These will reduce the amount you pay for your monthly premium.

We understand how confusing the new laws can be. Terpening Insurance is here to help. Contact us to learn more about your insurance options today!

Post author Loren Pleet