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Woman Flying

Know your plan and live fearless

There's no doubt that health insurance provides peace of mind. But is it really peace of mind if you don't know what's in your plan? Let's find out - so you can make a confident and informed decision this year.

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Get the worksheet
and get ready to enroll.

With your guided worksheet in hand, you can better prepare, understand your plan, and determine your health care needs during enrollment. You've got this.

In 4 easy steps, you can compare and contrast different plans, find which doctors and pharmacies are in network and calculate your overall maximum spend.

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Need help defining a word or two?

Our glossary of health insurance words and phrases will help you get to know your plan even better.

IN NETWORK

Refers to a group of doctors, hospitals or other specialists that agree to provide medical services at pre-negotiated prices and rates, which often means savings for you.

Out of network

Refers to a group of doctors, hospitals or other specialists who have NOT agreed to provide medical services at pre-negotiated prices and rates. You’ll pay more for out-of-network services, potentially significantly more.

Deductible

The amount you'll pay for in-network health services before your insurance begins to pay.

Premium

This is the monthly fee paid to your health insurance company, either by paycheck or payroll deduction.

Coinsurance

The percentage of the cost that you pay for in-network services AFTER you’ve reached your deductible and up to your coinsurance maximum or out-of-pocket maximum.

Provider

This is simply referring to your doctor.

Out of pocket

These are your expenses for medical care that aren’t reimbursed by your insurance. This includes your deductible, coinsurance and copayments.

Out-of-pocket limit

This number is the limit that you will pay for deductibles, copayments and coinsurance in a plan year. After you reach this limit, your plan pays 100% of the costs of benefits.

Copay

This is a fixed dollar amount you will pay for in-network services like a doctor’s visit or a prescription.

Flexible Spending Account (FSA)

This is a unique account that you can put pretax dollars into to help with out-of-pocket health care costs. An FSA does have specific restrictions: You can only use the money on plan-approved expenses. You don’t get back any money that goes unspent at the end of the year.

Health Savings Account (HSA)

This savings account is often used alongside a high-deductible health insurance policy that allows users to save money tax-free. HSA funds can only be used on specific out-of-pocket costs, but the balance at the end of the year rolls over into the next. The money is yours.

Can't Find the word you're looking for?

Common Questions

The Common Question:
PPO or High-Deductible Health Plan?

What is the difference?

  • PPO plans have copays but offer you a lower deductible.
  • PPO plans have a higher monthly premium.
  • HDHPs come with a lower monthly premium but have higher deductibles.
  • HDHPs also have higher out-of-pocket maximums every year.
  • HDHPs usually are paired with a health savings account (HSA).
 

Which one is for you?

PPO

The traditional PPO plan may make sense for you if you think you'll come in under your out-of-pocket maximum for health care this year or if you see the higher deductible being too expensive over the long term.

HDHP

These plans are designed to avoid out-of-control medical bills from long hospital stays and accidents, so a HDHP may be a good fit for you if you're healthy and would be able to cover the higher deductible and maximums for an unexpected illness or accident.

Both Plans Provide

  • Flexibility and control over your health care costs
  • Access to top doctors, specialists and hospitals
  • Preventive services that are fully covered
  • Online tools and services to help you stay healthy
  • Exclusive discounts on health and wellness programs

Still looking for more answers?

Discover more details and information about your plan and the plans
that you are comparing with these additional resources.

Find a Doc

Let Blue Cross Blue Shield help find a doctor in network.

Find a Pharmacy

Let's get you more information about pharmacies and your drug costs.

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Get 24/7 access to everything you need to manage your plan.

Ready to get started?

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