Learn how you and your employer share the costs for coverage

No matter which plan you choose, you can make choices about how and where you receive care, and anticipate ho you and your employer share costs. 

Learn about premiums, deductibles and out-of-pocket limits and find ways to keep expenses in check. 

Costs to use services

Along the way, you may also pay a fixed amount - or copay - for things like visits to your primary care physician.  Copays count toward your out-of-pocket limit.

You pay a set amount to have insurance (your premium)

To have health insurance, you and/or your employer pay a set amount called a premium, usually deducted from your employee paychecks. Think of paying your premiums like the membership fee you'd pay to belong to a gym.


1. You also pay to use any services, until you meet your deductible amount.

Once you begin seeing the doctor or using any medical services, most plans ask you to pay for care until you meet your deductible amount. Note that you may not be required to pay for certain routine care services. If your plan requires copays, keep in mind, they may not count toward your deductible.

2. If you meet your deductible, you and your plan share the responsibility to pay.

If you meet the plan's deductible amount, your plan starts to share costs. Often referred to as coinsurance, each plan agrees to pay a percentage of the cost. Generally, the plan pays 80% of costs, and you pay the remaining 20%.


3. If you meet your out-of-pocket limit, your plan pays everything.

If you reach the plan’s out-of-pocket limit amount, your plan pays all costs covered under the plan for the remainder of the year. Your amount includes what you paid for services until this point, but does not include your premiums.


Consider how you’ll use your plan

It's important to think about how cost sharing applies to the way you use your plan. When comparing plans, you’ll want to determine how much coverage you think you need and how it affects your costs.

Picking a plan

Choosing UnitedHealthcare

UnitedHealthcare helps you balance cost and coverage.

Checklist to pick a plan

Find the right plan for you with this checklist.

Getting married checklist

Decide which plans are right for you and your spouse.

Having a baby checklist

Understand what plan coverage you may need for pregnancy and delivery.

Changing health needs checklist

Consider what plan coverage you may need for your health condition.

Health insurance made easier

Understanding coverage

How to plan for the coverage you need.

Sharing costs

See how you and your plan share costs.

Terms to know

Start talking the talk—and understand what it means for you.