Co-pay & Deductible

by Guest » Tue Nov 23, 2010 01:24 am
Guest

Do I have deductible after paying my co-pay?

Total Comments: 8

Posted: Tue Nov 23, 2010 07:42 am Post Subject:

Deductible why?Once you paid for your copayment why it should be necessary?

Posted: Tue Nov 23, 2010 09:54 am Post Subject:

I don't think it would be easier for you to accept a coverage if it compels you to pay for the deductible alongside the copay or coinsurance. Copays and deductibles aren't usually offered together. It's advisable that you go through your policy papers carefully before signing in with a carrier.

Posted: Wed Nov 24, 2010 12:44 pm Post Subject:

Co-pays are flat fees to be met while the event takes place. It's not mandatory that your copay should count for the limit that you're supposed to meet out-of-pocket.

Posted: Wed Nov 24, 2010 09:09 pm Post Subject:

Deductible why?Once you paid for your copayment why it should be necessary?


and

Copays and deductibles aren't usually offered together.



Goody, you have put the cart before the horse. If there is a deductible it is either (2) payable in addition to any copay or (3) payable before a copay applies. It is always paid before coinsurance applies.

Steven, many PPO plans have deductibles AND copays in addition to coinsurance.

A PPO plan can include a deductible for out-of-network or certain other covered claims. For example, in my current PPO plan, my physician visits have a $20 copay, and my specialist visits have a $30 copay. If my orthopedic surgeon orders an MRI of my knee, that procedure is covered 70/30 AFTER a $250 annual deductible, and a $20 or $30 copay (in- or out-of-network) also applies to the procedure before the coinsurance applies. So my $1200 MRI, if I have not yet had any deductible expenses, is paid as follows: $30 copay out-of-network, $250 deductible applies to either $1200 (before copay) or $1170 (after copay -- the math is the same, either way). Amount subject to coinsurance is $920. 70% of $920 =$644, 30% of $920=$276. My total out of pocket expense = $30 + $250 + $276=$556 (or 46.3% of $1200 in this example).

Posted: Fri Nov 26, 2010 03:40 pm Post Subject:

You need to go to HR where you work and have them explain your insurance coverage to you and your options if you do not understand your policy. It is possible to have both just like someone else said you might have a 70/30 split after $250 dect.

Posted: Fri Nov 26, 2010 09:20 pm Post Subject:

It really depends on the plan. Some plans require you to pay your deductible first and then you are responsible for you coinsurance. Coinsurance is most commonly 70/30,80/20 or 100% Most coinsurance have a stop loss amount. Check your policy as it is very important to understand what your max out of pocket will be. Good luck!

Posted: Fri May 27, 2011 10:35 pm Post Subject: oEgueoXHeL

About15002.. WTF? :)

Posted: Fri Jun 03, 2011 01:35 pm Post Subject: pocMNjCvnmg

About15002.. Neat :)

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