When it’s time to choose a new health insurance plan, it may be tempting to simply pick the one with the lowest monthly payment — your premium. But there is a lot more to consider when it comes to figuring out how much your health insurance will cost you.
Beyond health insurance premiums
Your monthly premium is the amount you will pay to your health insurance company to keep your coverage active. But that is only the cost to buy the health plan. What will it cost you when you use your benefits, and will you have access to high-quality care?
It may seem obvious to choose the plan with the lowest premium, but a plan with a low premium may mean you have higher out-of-pocket expenses when you get care. This could cost you more in the long run if you require frequent health care.
Here are important factors to consider, in addition to the monthly premium:
- Are your preferred doctors and hospitals in the network?
- What services and prescription drugs are covered (or not covered)?
- How much will your health insurance company cover when you receive care?
- How much will you pay out of your own pocket for doctor visits, prescriptions, and hospital stays?
- Does your health plan have a deductible? How high is it, and what services will it apply to?
Out-of-pocket health insurance expenses
Here are some out-of-pocket expenses to consider:
- Copay. A copayment, or copay, is a set amount that you pay when you receive a covered health care service. For example, you may pay a $30 copay to see your primary care doctor.
- Coinsurance. Coinsurance is the percentage you pay out-of-pocket for some covered services. For example, if your coinsurance for radiology services is 20 percent, your health insurance company pays 80 percent of the cost, and you pay the remaining 20 percent.
- Deductible. Your deductible is the total amount you pay for health care services before your health insurance starts paying for some or all the costs. Every health plan has different deductibles, and deductibles may apply only to some services and not others.
There is also the out-of-pocket maximum, which is the most you will pay for covered in-network services in the plan year. Once you meet your annual out-of-pocket maximum, any in-network covered services are covered at 100 percent. All in-network out-of-pocket costs (i.e., copays, coinsurance, and deductibles) count toward your out-of-pocket maximum.
Every health insurance plan has different combinations of these costs, so check out which plan is best for you.
AmeriHealth provider networks
In addition to cost, be sure to consider the provider network of the health plan you choose. Are there specific doctors or hospitals that you would like to visit? You can check each plan’s network to see if your preferred providers are in the network. Do you often get a specific service or prescription drug? Be sure to find out if those are covered under your potential plan.
You can check to see if your doctor is an AmeriHealth in-network provider for the plan you’re choosing.
Health insurance tax credits, savings, and assistance
Some personal factors, like your age and household income, may impact the cost of your health plan. There are also many things that contribute to the overall cost of health care for everyone. This includes the cost of advanced medical technology, prescription drugs, the aging population, and covering the difference for Medicare and Medicaid payments.
Federal tax credits
Financial assistance is available for eligible applicants in the form of a tax credit (also known as a subsidy). There are two types of tax credits to help you pay for your health insurance if you are eligible:
- Premium tax credit: Lowers the monthly cost of your health insurance premium.
- Cost-share reduction (CSR): Lowers your out-of-pocket costs when you need care (for example, your copay when you see a doctor).
Some may also be eligible for health insurance through Medical Assistance, also known as Medicaid.
Update for 2026: In 2021, Congress expanded the eligibility of tax credits (subsidies) through the American Rescue Plan Act (ARPA) to make health coverage more affordable. Unless Congress extends the enhanced tax credits, they will expire at the end of 2025. But even if the enhanced tax credits expire, financial assistance will still be available for 2026 health plans at the pre-ARPA tax credit levels. You may still qualify for a tax credit based on your updated income and household information.
Find out if you are eligible for a tax credit using our online ACA Subsidy Calculator.
New Jersey Health Plan Savings (NJHPS)
New Jersey residents also have access to a state subsidy called New Jersey Health Plan Savings, which can help lower the cost of health insurance. Residents qualify for this subsidy based on income. Households with annual incomes up to 600 percent of the federal poverty level will receive NJHPS.
Alaska Native Claims Settlement Act (ANCSA) Corporation shareholders
If you are a member of a federally recognized tribe or are an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder, you may qualify for more savings.
AmeriHealth health insurance options
AmeriHealth health insurance options in New Jersey for 2026 have something for everyone, including affordable options, access to one of the largest networks of doctors and hospitals in New Jersey, and $0 copay for virtual care through Teladoc Health.
Find the AmeriHealth plan that’s right for you.
Do you need help determining which plan will work best for you? We can help! Call 1‑855‑832‑2008 (TTY: 711), Monday – Friday, 8 a.m. – 8 p.m., and Saturday, 10 a.m. – 2 p.m. EST.
