How do you pay for health insurance? Do you pay for it only once or every month? Does the cost increase when more medications are added or when there are different medications being prescribed to different family members?
Once you use your health insurance, you might need to also pay deductibles, depending on what type of coverage you have. Deductibles are the money you shell out before the health insurance starts paying for your medical expenses. These deductibles may vary from $250 per year per policy holder, or more, per family, depending on the requirement of the health insurance. The policy holder is the owner of the health insurance plan. The deductible is the maximum amount shelled out by the policy holder for the year. For example, if your health insurance policy covers a deductible of $500 per year and you bought medicines worth $150 and this is the first time you bought medicines for the year, you still have $350 left to pay toward your deductible. You will continue to pay for additional medications until you reach the maximum amount of $500. Once the deductible limit has been reached, the health insurance will then continue to pay for the additional medications or medical expenses, but you might still have to pay a percentage which is called a co-pay or co-insurance. Once the health insurance is paying for your family’s medical expenses, you must now consider the doctor or provider that you will use. If you use the services of the doctor that belongs to the network of doctors and medical specialists that are accredited by the health insurance company, the insurance pays most of the bill. This is done as most health insurance companies have prior negotiations to get the services of the accredited members of the network at a lower cost. If you use a doctor or provider that does not belong to the network, you will probably pay more of the medical expenses. For example, you and your daughter need to get some tests done that are worth $300 each. If you avail of these tests in a provider that is accredited to your health insurance’s network, the insurance might pay 80% of the total costs, depending on the terms of your policy, which is $240. You will only pay $60 However, if you avail of these tests in a provider that does not belong in the network, the insurance may only pay 70% of the total costs, again depending on the terms of your policy,, which is $210, and you will pay $90. Both you and the health insurance company save money if you use the medical services from the doctors and providers that belong in the network. The health insurance might also have an out-of-pocket maximum which you must check. This is the maximum amount that you pay for the year. Once you reach this amount, the health insurance will cover 100% of the total expenses. For example, your son is real sick and needs to undergo surgery. You learned that the out-of-pocket amount stated in your health insurance plan is $5,000, and the surgery costs $12,000. You will only pay $5,000, and the remaining $7,000 will be shouldered by your health insurance plan. Another thing that you need to check is the co-pay amount. The co-pay is the amount that you spend when you consult a doctor for a routine checkup or any other medical service that requires copay. The co-pay usually costs $15-20 per doctor’s visit, if you have a good health plan. For example, your co-pay amount is $20. You have a routine checkup with your doctor which costs $150. You only pay the $20, and the health insurance pays for the remaining $130. Try to check the guidelines for co-pay and deductibles as some health insurance companies consider the co-pay as part of the deductibles. Health insurance coverage depends on the number of family members. It is better to check your plan’s guidelines and requirements for premiums, deductibles, out-of-pocket maximum, accredited doctors and medical specialists, and co-pay amount. These amounts do not increase even if you need more medications. Answer by general public — May 22, 2009 @ 12:11 am No CommentsNo comments yet. Leave a comment |
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If you sign up for a health insurance plan, you need to pay a premium. Premiums are paid on a regular schedule – every month, twice a month, etc. They are often automatically deducted from the payroll if you are insured under a group health insurance plan. Payment of premiums is required if you want to keep your health insurance.
