what are copays deductibles and coinsurance 
most health insurance plans require their customers to pick up some of the costs of their coverage in various ways insurance plans with higher out of pocket costs generally have smaller monthly premiums when shopping for plans weigh the benefit of lower monthly payments against the potential risk of large out of pocket expenses in the case of a major illness or accident if you re self employed you may be able to deduct up to 100 of health insurance premiums you pay out of pocket high deductible health plans hdhp one increasingly popular type of health insurance is the high deductible health plan hdhp these plans have higher deductibles and lower monthly premiums their users are the only ones eligible to open a health savings account hsa that has substantial federal tax benefits for 2024 a high deductible health plan is one that has deductibles of at least 1 600 for an individual or 3 100 for a family total out of pocket maximums are 8 050 for an individual and 16 100 for a family high deductible health plans offer a unique advantage in that if you have one you re permitted to open and contribute pretax income to a health savings account which can be used to pay for qualified medical expenses these plans offer a triple tax benefit in that you can withdraw money from an hsa after age 65 for any reason with no tax penalty but you will pay income tax on the withdrawal if the money is not used for qualified medical expenses federal health insurance plansnot all health insurance in the us is provided by private companies medicare medicaid and the children s health insurance program chip are federal health insurance plans that extend coverage to older disabled and low income people in 2010 president barack obama signed the affordable care act aca into law in participating states the act expanded medicaid a government program that provides medical care for individuals with low incomes the affordable care act has prohibited insurance companies from denying coverage to patients with preexisting conditions and has allowed children to remain on their parents insurance plan until they reach the age of 26 in addition to these changes the aca established the federal health insurance marketplace it also prohibits insurance companies from denying coverage to patients with preexisting conditions and allows children to remain on their parents insurance plan until they reach age 26 the marketplace helps individuals and businesses shop for quality insurance plans at affordable rates insurance available through the aca marketplace is required to cover 10 essential health benefits under the aca tax payers were required to carry medical insurance that meets federally designated minimum standards or face a tax penalty but the tax cuts and job act removed that penalty after december 31 2018 a supreme court ruling in 2012 struck down an aca provision that required states to expand medicaid eligibility as a condition for receiving federal medicaid funding and a number of states chose to refuse to expand their medicaid programs as of 2023 an estimated 40 million people have health coverage through the affordable care act two public health insurance plans medicare and the children s health insurance program chip provide subsidized coverage for disabled individuals and children medicare which is available to people age 65 or older also serves people with certain disabilities end stage renal disease and als the chip plan provides health coverage for low income children under the age of 19 medicaid can help older seniors to pay for long term care in a nursing home but medicare does not this is why medicare recipients often pay for supplemental coverage through a private insurer 