When you enroll in a health plan, the insurance company agrees to pay for certain medical services, such as preventive care and other covered medical services.
Having health insurance means you can better manage your health and live life to the fullest. Once you’ve applied for individual medical coverage and made your first month’s payment, you’ll be issued a health insurance policy with a date indicating when your coverage begins.
Each month, you pay a premium, which is a monthly bill for your health plan. While you’re responsible for your premium, you may qualify for government assistance to help pay part of it. This financial aid is called a tax credit or advance premium subsidy.
The government will send the subsidy directly to your health insurance company, reducing the cost of your monthly payment.
Most plans have a deductible, which is the amount you must pay out of pocket each year before your health plan begins to pay its share.
The deductible may apply to all covered services or only to selected covered services, depending on your plan.
You may also have to pay part of the cost of some covered services even after you meet your deductible. This is called cost-sharing and can include things like copays (fixed fees you pay for covered health services) or coinsurance (a percentage of a covered medical bill).
Most health plans have a network, or a list of doctors, hospitals, and other healthcare providers you can choose from. These are called in-network healthcare providers.
Going to these providers when you need care will generally save you more money. If you go to a provider outside your plan’s network, you may have to pay more.
Your plan will have an annual out-of-pocket maximum, which is the most you’ll pay each year for covered services under your health insurance plan.
After you’ve paid this amount, your insurance covers 100% of covered medical expenses for the rest of the calendar year.
Health insurance plans may also offer benefits at no additional cost to you, such as health and wellness reward programs and discounts on services and products.
If you need help, you’re not alone. Florida Blue has served the state for 80 years and is the only insurer offering health plans in every Florida county. Call 877-352-5830 or visit FloridaBlue.com for assistance in finding the right plan and ensuring you get the financial help you qualify for.
Florida Blue is a trade name of Blue Cross and Blue Shield of Florida Inc., an independent licensee of the Blue Cross and Blue Shield Association.
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