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Health insurance

A Quick Look at How Health Insurance Works in the US

A Quick Look at How Health Insurance Works in the US

We know that the world of health insurance can be difficult to understand. Let me explain clearly how the health insurance system works in the United States. I’ll walk you through the key concepts, from the options available to terms like copays and deductibles.

The available alternatives

Imagine health insurance as a menu with many options. Each option is a “plan” with its own characteristics and benefits. The monthly premiums for some plans may be lower, but you may pay more when you need medical care. Other plans may have higher premiums, but when you get care, you’ll have fewer expenses.


A “copay” is similar to admission to a theme park. It’s the amount you pay when you get medical care, like a doctor’s visit or prescription drugs. If your office visit copay is $20, you would only pay $20 at the office visit and your insurance would cover the rest.


The “deductible” is like a limit that you must exceed before the insurance begins to pay. If you have a $1,000 deductible, you should pay your medical expenses up to that amount. The insurance will start paying after that.


Past medical histories are similar to “pre-existing conditions.” These are medical problems you had before you got insurance. Deadlines may be required to meet some plans. However, there are restrictions in health insurance laws on how they can affect your eligibility and expenses.

An example of how it works

Imagine you have an insurance plan that has a $150 monthly premium, a $1,500 deductible, and a $30 copay for doctor visits. At the time of the visit, you would pay $30 if you need a visit to the doctor that costs $100. Insurance would start splitting costs if you spend $1,500 on health care for a year.

Don’t worry if these concepts are still a bit confusing for you. Here we are to help you. As specialists at Calma Insurance, we are at your disposal to answer any questions you may have about health insurance. Our goal is to find the best “deal” for you and your family, giving you peace of mind and first-class medical care.

Calma Insurance will help you find peace at the best price available

At Calma Insurance, we understand that the search for health insurance can be overwhelming. However, you are not alone on this expedition. Our specialists are available to help you through the process, answer your questions, and ensure you have the best health insurance to fit your needs and budget.

Ensure your well-being and that of your family!

Contact us now and our insurance experts will help you find the perfect plan for your needs.

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