Where Does Your Insurance Payment Really Go?

Availing a health insurance plan to secure your retirement is a great investment. Making sure that your money is going somewhere, and that you are not wasting your time now, gives you a sense of peace.

Note that before you invest in an insurance plan, experts advise you to complete your emergency fund first, so you won’t end up prematurely withdrawing your insurance if something happens.

Coins time

Now, before you avail your insurance plan, let’s take a look at where your money really goes when you pay for your insurance.


Deductible. This is what the insurance plan will deduct to your total coverage amount. That means you have to pay this amount first when you avail the health services before your plan provider takes over and pay for your expenses.

Copayments and coinsurance. After you reach your deductibles, your plan provider will take over and pay for the expenses when you get a medical service. But you still have to pay for some expenses even when the plan is covering you already. Those are copayments and coinsurance payments.

Out-of-pocket maximum. After the deductibles and copayments reach a certain amount which is your out-of-pocket maximum, your plan provider will take over and pay for 100% of your expenses.

Co-related to the categories

This is where the percentages that you see in the categories come in. As a rule of thumb, if you don’t use regular medical services and you also don’t take regular prescriptions, you may want to choose the bronze category for your plan. This will ensure that you will not be paying more than what you will use.

Moreover, if you have maintenance medicines, or you visit your health care centers regularly, you will be better off with the gold or platinum category.

As a review, here are the different plan categories and their percentage:

  • Bronze – 60%
  • Silver – 70%
  • Gold – 80%
  • Platinum – 90%

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