Why health insurance is important

Health insurance provides important financial protection in case you have a serious accident or sickness.

People without health coverage are exposed to these costs. This can sometimes lead people without coverage into deep debt or even into bankruptcy.

It’s easy to underestimate how much medical care can cost:

Fixing a broken leg can cost up to $7,500
The average cost of a 3-day hospital stay is around $30,000
Comprehensive cancer care can cost hundreds of thousands of dollars

Having health coverage can help protect you from high, unexpected costs like these.

How a Marketplace health insurance plan protects you

When you have coverage, your plan protects you from high medical expenses 3 ways:

Reduced costs after you meet your deductible Once your spending for covered services reaches your plan’s

deductible

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself. Refer to glossary for more details.

Example: If your plan has a $1,000 deductible, you pay the first $1,000 in covered services. After that, your plan pays between 60% and 90% of your covered expenses, depending of what kind of plan you have. You pay between 10% and 40% of the costs as

coinsurance

The percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible. Refer to glossary for more details.

copayments

A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible. Refer to glossary for more details.

Example: If your plan has a $3,000 out-of-pocket maximum, once you pay $3,000 in deductibles, coinsurance, and copayments the plan pays for any covered care for the rest of the year. This provides important peace of mind and protection from very high medical costs.

essential health benefits

A set of 10 categories of services health insurance plans must cover under the Affordable Care Act. These include doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more. Some plans cover more services. Refer to glossary for more details.