Key Words to Know When Picking a Health Plan

Nov. 5, 2020

Health insurance has a language of its own. If you are getting started with selecting your health plan for 2021, you may encounter some words you aren’t familiar with. Here’s a look at some key terms to know during this open enrollment period. They may help if you want to buy a plan through the Health Insurance Marketplace. 

If you do not have health insurance through your workplace, Medicare, Medicaid or the Children's Health Insurance Program (CHIP), you can purchase insurance in the marketplace during open enrollment. 

Open enrollment is the period during which you can select a new health plan for the coming year. This year it runs from Nov. 1 until Dec. 15 — a short, 45-day window. Coverage will start on Jan. 1, 2021. 

If you do not enroll in a plan by Dec. 15, you cannot enroll in a plan for 2021 unless you qualify for a special enrollment period. 

A special enrollment period is when you have a qualifying life event that allows you to then enroll in a health plan. Those events include losing health coverage, getting married, having a baby or adopting a child. 

One of the first things you will need to know when selecting a health insurance plan is whether you qualify for any savings on coverage for the year. 

Subsidies or premium tax credits make coverage available at reduced or no cost for people with incomes below certain levels. You can find out what savings you may qualify for by using this tool on BlueCross BlueShield of South Carolina’s team can help you make sure you get the right savings on your health plan and better understand your options

These tax credits will make your premium lower. The premium is the amount you pay each month for insurance. 

Some of these savings may also be applied to your deductible or copayment. A deductible is the amount you pay for covered health care services before your insurance plan starts to pay. The copayment is a fixed amount ($20, for example) you pay each time you use a covered health care service after you've paid your deductible.

You may also see the term coinsurance. Like a copayment, it is the amount you pay for covered services after you have paid your deductible. Coinsurance is the percentage of costs of a covered health care service you pay (20 percent, for example) after you've paid your deductible. 

When picking the right plan for you and your family, it is important to consider all the costs, not just the monthly premium. For example, plans with lower monthly premiums may have higher deductibles. 

For help with finding the right plan, you can call a BlueCross agent, who can help you understand the marketplace and find the best insurance plan for your circumstances. You can find an agent in your area, or call us and speak with an agent directly. Call 855-244-3694 or find an agent online

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