Parts of a Health Plan

Introducing costs, benefits and networks

Parts of a Health Plan

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The Parts of a Health Plan

You can think of a health plan as three main parts: benefits, networks and costs. Click below to learn more about each.

What You Need to Know About Benefits

Benefits are simply what your plan pays for – things like checkups, prescriptions and medical care. Your health plan covers some benefits, like wellness visits and preventive care, at 100%. In other cases, as with surgery, you may pay a deductible and your health plan then covers a percentage of the cost, and you pay the rest. In general, the more your health plan pays toward your medical costs, the higher your monthly payments (premiums) will be.

TIP: Look for health plans that include unique or exclusive benefits such as discounted gym memberships and special promotional offers. These extra benefits help your money go farther.

Learn more about networks

What You Need to Know About Networks

When you buy a health plan, you choose a network. A network is a group of doctors, hospitals and other health care providers who provide services at lower rates that BlueCross has negotiated on behalf of its members. When you use a doctor or hospital outside of your network, you pay more, so it’s important to understand which providers are included in your health plan's networks before you enroll.

What You Need to Know About Costs

You’ve probably heard about health insurance costs like premiums, deductibles, copayments and coinsurance. These play a big role in helping you manage your health care expenses.

For example, you can choose a plan with a higher monthly premium, and lower out-of-pocket costs (deductibles and coinsurance) for health care and services. If you have few or no expected health needs, you may prefer a plan with a lower premium and higher out-of-pocket costs.

TIP: Things like network and coverage affect what you pay for your health plan. For example:

  • Health plans with smaller provider networks usually have lower monthly payments, but they include fewer choices of in-network doctors and hospitals.
  • Health plans with greater benefit coverage and lower out-of-pocket costs – like deductibles and coinsurance – but they have higher monthly premiums.

If you’ve never had insurance before, it can be intimidating to predict your healthcare needs and their costs. You can learn more about costs here:

Learn more about costs

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Better Tennessee celebrates the people and organizations dedicated to improving the health of Tennesseans.

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