U-Haul POS health

Some plans have a separate deductible for prescription drugs. For example, when your coverage year under the plan begins, you may have to pay the first $100 in prescription costs yourself before the insurance company starts sharing those costs.

The amount your insurance company will pay for a prescription drug typically depends on its drug “tier” — a category determined by each insurance company. In a three-tier plan, you’ll pay the lowest amount for Tier 1 drugs, which are almost always generic versions of medications. You’ll pay the next-lowest amount for Tier 2 drugs, which are brand-name medications your insurance company would prefer you to use because they are as effective as drugs in Tier 3, but they cost less. You’ll pay the most for Tier 3 drugs, which typically are specialty drugs, or brand-name drugs that have a lower-cost, equally effective alternative. For example, you might have to pay $10 when filling a prescription for a Tier 1 drug, $35 for Tier 2 and $70 for Tier 3.

What’s the difference between “in-network” and “out-of-network”?

For many plans, the insurance company contracts with specific doctors, hospitals, laboratories and other providers to provide health care to plan members. (These contracts can include agreements on things like standards of care and the prices of medical services.) These health care providers are referred to as “in-network, ” “preferred” or “participating” providers. Providers the insurance company does not have contracts with are described as “out-of-network.”

This distinction can greatly affect your costs. Some insurers, like many health maintenance organizations (HMOs) and exclusive provider organizations (EPOs), generally limit coverage to care from providers in their network; they will help you pay for out-of-network care only in an emergency or under special circumstances. (CareConnect is an EPO.) Others, like many preferred provider organizations (PPOs) and point-of-service (POS) plans, allow you to use out-of-network providers but require you to pay a significantly higher share of your bill when you do.

What’s a health savings account (HSA)?

Some low-premium plans combine a high deductible (as of 2017, at least $1, 300 for an individual or $2, 600 for a family) with a special kind of savings account, called a health savings account (HSA). You can withdraw money from this account to help pay your share of the bills for medical services and prescription drug costs.