Is The Cost Of Health Insurance Your Biggest Problem? Find An Affordable AND Comprehensive Plan With EZ

Looking for a comprehensive health insurance plan but working with a tight budget? You can absolutely find a plan that offers you the coverage you need, while still staying in your price range. But in order to find the plan that offers you the most bang for your buck, you’ll need to understand how much you’ll actually end up spending out-of-pocket for your policy. Don’t worry: that’s what EZ is here for! EZ understands how important it is to find a plan that fits in your budget, but also has the right coverage, so we’ll break down everything that determines the price of your health insurance plan, and we’ll show you how you can find an affordable, comprehensive plan. And we’ll do it all for free, so you can save even more money!

Monthly Premiums

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Your monthly premiums will depend on the type of plan you have and other factors.

One of the main expenses when it comes to your health insurance policy is the monthly premiums. This monthly rate partially depends on the size of your family, your age, and your location, but the amount you pay will also depend on what type of plan you choose. For example, when purchasing a plan on the ACA Marketplace, you’ll have to decide between Platinum, Gold, Silver and Bronze plans, which will affect how much you pay in premiums versus how much of your medical expenses the plan will cover. You’ll also have multiple options when it comes to policy type, like PPO or HMO, which will affect the type of network you have access to. Each type of plan offers different levels of coverage with different monthly premium prices, so the best way to find a policy with a premium that meets your budget but still covers your medical expenses is to work with an EZ agent. Our agents work with the top-rated insurance companies in the country, so we can find you an affordable plan with low monthly premiums.


In order for your plan to start paying its share of costs, you will first have to pay a certain amount out-of-pocket for your care, otherwise known as your deductible. Meeting your deductible is generally where a lot of your money goes when it comes to your policy; for example, your plan might have a $2,500 deductible, which means you will have to pay this amount in medical bills before your insurance company will begin to pay your medical expenses. 

When it comes to health insurance plans, you have the option to choose between a lower deductible or a higher deductible. High-deductible plans have low monthly premiums, so if you are looking to save money, these plans are tempting. But know that if you are in an accident or have a medical emergency, you will have to pay the high deductible before your plan begins to cover you. High-deductible plans are generally more suitable for healthy people who do not need to see the doctor very often; if this is the case for you, one of these plans can save you a lot of money, because your premiums will be lower. Our trained agents can help guide you in the right direction to make sure you are covered completely. 

Copays & Coinsurance

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After meeting your deductible, when you receive medical treatments, you will have to pay a coinsurance.

When budgeting for your health insurance plan, you’ll also have to take into account other expenses in addition to your premiums and deductible: copays and  coinsurance. Copays are a fixed amount you will pay when you see a doctor or specialist and for medications. 

Once you meet your deductible, you will also most likely have coinsurance to pay. This is the amount of money your health insurance company expects you to pay towards your care once they begin contributing. Coinsurance is normally 20% after you meet your deductible. 

Your EZ agent will not only look for plans with lower copays, but they will also go over each plan and break down how things like coinsurance will affect the price of your policy. This means you will know exactly what to expect when it comes to your actual healthcare expenses.

Out-Of-Pocket Maximum

Every plan has an out-of-pocket maximum, which means once you have reached a certain amount of out-of-pocket expenses, your plan will begin to cover everything. For example, if your out-of-pocket maximum is $5,000 and you reach that amount before the year is over, your health insurance plan will pay for all of your medical expenses until the new calendar year begins. We can help you find a plan that has a lower out-of-pocket maximum, so that you’re more likely to end up having your medical expenses fully covered by your plan. This is especially vital if you have a medical condition which requires ongoing treatment: having a plan with a lower deductible and a low out-of-pocket maximum could help you save hundreds of dollars. The key to finding a plan like this is comparing plans with an EZ agent!

We all want to save as much money as we can, especially when it comes to a health insurance plan. Health insurance can be quite expensive, but with professional, highly-trained agents on your side, you can find an affordable plan with the right coverage for your needs. Our agents work with the top-rated insurance companies in the nation, and will compare plans at no cost to you. Health insurance is expensive enough, which is why we offer our services for free. We genuinely want to help you find a great affordable plan, not make money off of you. To get free instant quotes, simply enter your zip code in the bar above, or to speak with a local agent, call 888-350-1890.

Out-of-Pocket Maximum Explained

Medical bills can be a huge source of stress. They can seem like they are never ending, but there is actually a limit on how much you can spend on out-of-pocket healthcare costs. The out-of-pocket maximum, which is the annual limit that you are required to pay for covered health services, is your financial saving grace. Each health insurance plan has different out-of-pocket maximums. Understanding yours will help you get a better handle on how much you will be paying out-of-pocket with your policy. 

What Is an Out-of-Pocket Maximum?caucasian mans hand pointing at the end of a br that says maximum

An out-of-pocket maximum is the amount that you will have to pay for covered health services. Once you reach that amount, your insurance will pay for all covered services. All copayments, deductibles, and coinsurance count towards your out-of-pocket maximum. However, your  monthly premium payments do not go towards your out-of-pocket maximum. 

How It Works

If you need a medical procedure, generally you and your  insurance company will each pay a portion of the cost. You will pay enough to meet your annual deductible, and your insurance company will pay for the rest of the procedure, unless you have to pay coinsurance as part of your policy. If your plan does require you to pay coinsurance then you will also have to pay 20% (usually) of the cost of the procedure, even after meeting your deductible.

After you have met your deductible, you will continue to pay copays and coinsurance until you meet your out-of-pocket maximum. After you meet your maximum, insurance will then pay 100% of any medical costs. You will not have to pay for copays or coinsurance after meeting your maximum. 

calculator on paper with a pen sitting on top of it in the paper.
After you have met your deductible, you will continue to pay copays and coinsurance until you meet your out-of-pocket maximum.

Here’s an example to illustrate how out-of-pocket maximums work. Let’s say Mary has a health insurance plan with a $2,000 deductible, a 20% coinsurance requirement for all care after meeting the deductible, and a $5,000 out-of-pocket maximum. She has to have surgery and the total hospital bill is $20,000. The costs will break down like this:

  • Mary will pay her $2,000 deductible, leaving $18,000 of the bill. 
  • Her coinsurance requirement is 20% of the $18,000, which is $5400. But because Mary’s plan has an out-of-pocket maximum, she and her insurance company will end up each paying part of this cost.
  • Mary has already paid $2,000 to meet her deductible, and her out-of-pocket maximum is $5,000 so instead of owing $5,400 in coinsurance payments, she only owes $3,000 ($2,000 deductible + $3,000 coinsurance = $5,000 maximum out-of-pocket payment). 
  • Her insurance company will now cover the remaining $13,000 of the cost of the procedure.

Do All Plans Have a Maximum?

All plans that meet ACA standards have out-of-pocket maximums. For 2020, that number is $8,2000 for individuals and $16,400 for families. Some plans may have a lower maximum, but none will be higher than those amounts. Plans with higher monthly premiums generally have lower out-of-pocket maximums, while plans with  lower monthly premium plans, like  catastrophic or high-deductible health plans, have higher out-of-pocket maximums. 

In order to find the right plan for your needs and budget, you have to take into account everything that it has to offer, including things like out-of-pocket maximums. Doing all the research alone is time-consuming and can cause confusion and missed opportunities. EZ will make the process quick and painless; we’ll explain everything clearly, give you real-world examples of how the plan would work for you, compare quotes, and calculate costs for you. We will set you up with one agent that will help you find the right plan for your medical and financial needs. To start saving, enter your zip code in the bar above, or to speak to one of our licensed agents, call 888-350-1890.