Picking a health insurance plan takes some prep work. We'll help you simplify the process and understand how to compare plans.
Savings and subsidies
There are two types of savings programs that can lower what you pay each month and out of pocket for your individual or family plan — and over 80% of Highmark ACA members qualify.*
Advanced Premium Tax Credits (APTC) - These can lower your monthly premium and are based on your household income and household size.
Cost-Sharing Reduction (CSR) - This program can help lower the out-of-pocket costs that come when you receive care, like deductibles and copays.
Depending on your household size and income, you may be eligible for both an APTC and a CSR.
Deductibles and premiums
A good rule of thumb when it comes to deductibles and premiums is to picture a see-saw: when you lower one, you generally raise the other. This makes it easier to choose an individual or family plan based upon how much you're likely to use it.
High Premium = Low Deductible
Low deductible plans tend to have higher premiums (monthly bills), but may save you money over the long run if you need a lot of health services.
You may want to consider a High Premium / Low Deductible plan if you are:
Pregnant or planning to become pregnant.
Planning major surgery.
Have children in sports who risk injury.
Have a chronic condition.
Take prescription medication.
Low Premium = High Deductible
High deductible plans have higher out-of-pocket costs if you need medical care, but may save you money if you don’t have many health care needs.
You may want to consider a Low Premium / High Deductible plan if you are:
Healthy and rarely sick.
In this five-minute video, we'll help you understand the different metal levels and how to choose one that fits your life.
Remember: Metal levels only pertain to how you and your insurance company share costs. You get the same high quality of care regardless of metal level.
Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.
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