Types of California Health Insurance Payments Defined

Types of California Health Insurance Payments Defined

Decoding the terminology in California health insurance plans can be a difficult task so we have included this article to help you define the terms that are used in group health insurance and individual health insurance. Here we will define premium, deductible and co-pay:

The Premium

The premium of a health insurance plan is the money that the individual or group needs to plan on a monthly or annual basis to ensure health insurance coverage under the health insurance policy. This amount is usually fixed and is determined based on a number of factors including where the individual lives, if he/she has any preexisting medical conditions, what type of health insurance plan the individual wants and can vary depending on the amount of a person’s deductible and co-pay. Some people opt to have a higher or lower premium based on their financial situation. For instance, someone without a history of savings might want to have a higher monthly premium on their California health insurance plan because it can benefit them by having a lower deductible and copayment.

The Deductible

The deductible is determined by the health care plan company and will vary based on the premium and the copayment. The deductible is the amount of money that the individual or group must pay in order for their health insurance plan pays its portion of the health care plan. The deductible can vary based on the services desired to be covered or it can be a fixed amount that is paid at the beginning of the year, or broken into monthly payments. The deductible in a Califonria health care plan is usually determined based on the type of service such as a surgery, emergency room visit, or specialized service and can vary drastically from health insurance company to health insurance company.

The Co-Pay

The copayment, more commonly referred to as co-pay, is the amount that the individual or group needs to pay for services such as doctor appointments, visits, medical prescriptions and other services. The co-pay is a payment that is fixed and will be paid by the individual or group everything a service, appointment or prescription is desired.

Please see “Understanding HMO, PPO, and POS Health Insurance Plans” for further information on health insurance plan terminology.

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