Speaker 1:  When it comes to your health plan, it's important to understand your benefits and any costs you may have to pay. Things like copays, coinsurance, and deductibles. To make it a little easier, here's an example of a person and his health care journey.

This is Ben. Ben's a regular guy. He works hard and he plays hard. Sometimes too hard. Luckily, Ben chose HAP as his health plan. When he hurt his shoulder skiing, Ben went to see his doctor. He paid a $35 copay for the office visit. A copay is a fixed amount you pay each time for a healthcare service like doctor visits or the purchase of medications or other medical supplies.

After a few weeks, Ben's shoulder still hurt, so his doctor sent Ben to get an MRI, which costs $1,000. Ben's health plan has a $2,000 deductible. A deductible is the amount you need to pay for certain covered services before your health plan begins to pay for them. So Ben paid the full $1,000 for the MRI. Unfortunately, Ben's MRI showed that he needed surgery. Sorry, Ben. But thankfully, Ben's doctor knew a specialist who was great at fixing up shoulders.

Ben's surgery and hospital stay totaled $12,000. Because Ben had $1,000 left before he met his deductible, he paid $1,000 toward the bill. Ben's plan also has 20% coinsurance. Coinsurance is the percentage of charges for certain covered services that you pay after your deductible has been met. So Ben also paid an additional $2,200, or 20% of the remaining $11,000, and HAP paid the rest.

After paying his co-pays for several rounds of physical therapy, Ben's shoulder felt great, plus he had met his $4,500 out-of-pocket limit. The out-of-pocket limit is the most you'll pay for the combined total of copays, coinsurance and deductibles in a benefit period, which is usually a calendar year. Once you meet your out-of-pocket limit, HAP pays all of the allowed amount for covered services. That means HAP will pay the full cost for all medical services if anything else were to happen to Ben this year. Even if he just gets sick.

Make sure you know all the costs involved with your health plan. To see the full range of plans HAP offers, visit chooseHAP.org. All plans are different. For specific cost information, please consult your benefits guide or contact HAP.