How Health Insurance Works
Have questions about how health insurance works? You've come to the right place. We've covered the basics of health insurance for you below. We explain the differences between deductibles, coinsurance and copays, in-network and out-of-network benefits, HMO and PPO plans and more.
What you pay
Figuring out your share of the cost for health care can be confusing. These articles will help you understand what you pay and what your health insurance pays.
- How do deductibles, coinsurance and copays work?
This page defines the common terms deductible, coinsurance and copay, and explains how they affect your health care costs.
- How to understand deductibles and their impact on premiums
Learn how the deductible you choose affects how much your health insurance premium will be.
- What is coinsurance and how does it work?
This explains the practice of having you share the cost of health services with your insurance company.
- How do out-of-pocket maximums work?
Learn how out-of-pocket maximums affect your annual health care budget.
- How do tiered copays work?
Does your Blue Cross Blue Shield of Michigan plan offer tiered copays? Learn more about how they work and what you can expect to pay for office visits.
- What’s the difference between in-network and out-of-network benefits?
Learn how choosing between in-network or out-of-network doctors and facilities can affect how much you pay for your health care services.
How insurance networks work
Knowing about your plan's network is important. It affects which doctors you can see and how much you pay for care. Learn more about our networks below.
- What’s the difference between HMO, PPO and EPO plans?
Watch a video and find out more about what makes HMOs, PPOs and EPOs unique so you can choose the one that’s right for your health care needs.
- What are local health insurance networks and how do they work?
Find out more about Metro Detroit HMO, Partnered HMO and Metro Detroit EPO, our local health insurance networks in Michigan.
- What do I need to know about the different Blues networks?
Learn about our networks so you can choose and go to the right doctor or hospital.
How to get the most value from your coverage
Health insurance is a big expense. Learn how to keep your costs manageable, and how to use your coverage to the fullest.