If the annual deductible is $1500 and the services provided say no coinsurance, does that mean the employee pays 100% of everything every time they go to the dr?
Total Comments: 23
Posted: Sun Oct 23, 2011 10:02 pm Post Subject:
Simply put, it means that you are responsible for paying for your deductible, and once that it is fulfilled your insurance should cover %100 of the costs. Co-insurance should make you pay for only a determined percentage beforehand, but if you don't have it you have to pay those costs.
Posted: Fri Dec 09, 2011 06:57 pm Post Subject: coinsurance
I am taking out a policy that has 3500.00 deductable and no coinsurance. the dr visits are 35.00 copay with out having to meet the deductable. does this sound reasonable?
Posted: Fri Dec 09, 2011 10:31 pm Post Subject:
It does not sound unreasonable. Is this for you as an individual or for you and your family?
I assume this is for a PPO plan? An HMO would probably not include a deductible.
Have you looked into a HEALTH SAVINGS ACCOUNT (HSA) in combination with a HIGH DEDUCTIBLE HEALTH PLAN (HDHP)? It could save you money at the same time you are saving money for your future medical claims.
The individual deductible limit is much lower than $3500. And you can fully fund your HSA to the amount of the deductible (or very nearly so) with tax-deductible dollars and earn tax-deferred growth (using those dollars for qualified health care expenses is also tax-free). Once you satisfy your deductible for the year, most HDHPs cover the rest of your covered expenses 100%. You just keep paying the monthly premiums, which should be comparable to or lower than what you've been quoted.
Also, courtesy of the PPACA, wellness visits (preventive care) to your physician must now be provided without a copay or deductible, regardless of the type of insurance plan you have. And no upcharges for EMERGENCY ROOM copays compared to regular copays, in most cases, but for all after 1-1-2014 (unless Congress makes changes between now and then).
Posted: Sun Oct 23, 2011 10:02 pm Post Subject:
Simply put, it means that you are responsible for paying for your deductible, and once that it is fulfilled your insurance should cover %100 of the costs. Co-insurance should make you pay for only a determined percentage beforehand, but if you don't have it you have to pay those costs.
Posted: Fri Dec 09, 2011 06:57 pm Post Subject: coinsurance
I am taking out a policy that has 3500.00 deductable and no coinsurance. the dr visits are 35.00 copay with out having to meet the deductable. does this sound reasonable?
Posted: Fri Dec 09, 2011 10:31 pm Post Subject:
It does not sound unreasonable. Is this for you as an individual or for you and your family?
I assume this is for a PPO plan? An HMO would probably not include a deductible.
Have you looked into a HEALTH SAVINGS ACCOUNT (HSA) in combination with a HIGH DEDUCTIBLE HEALTH PLAN (HDHP)? It could save you money at the same time you are saving money for your future medical claims.
The individual deductible limit is much lower than $3500. And you can fully fund your HSA to the amount of the deductible (or very nearly so) with tax-deductible dollars and earn tax-deferred growth (using those dollars for qualified health care expenses is also tax-free). Once you satisfy your deductible for the year, most HDHPs cover the rest of your covered expenses 100%. You just keep paying the monthly premiums, which should be comparable to or lower than what you've been quoted.
Also, courtesy of the PPACA, wellness visits (preventive care) to your physician must now be provided without a copay or deductible, regardless of the type of insurance plan you have. And no upcharges for EMERGENCY ROOM copays compared to regular copays, in most cases, but for all after 1-1-2014 (unless Congress makes changes between now and then).
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