Insurance Basics: Deductible & Coinsurance

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PostPosted: Fri Apr 29, 2011 3:19 pm   Post subject: deductible and coinsurance  

I have 600 deductible, 80/20 coinsurance. Before surgery, I paid 350 to Doctor and 600 to hospital. After the surgery I paid 100 for tomography. I have 444 dollar pathology bill from hospital and my insurance says I had to pay all money because deductible...Didn't I paid deductible yet....Help please...


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melinda1
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PostPosted: Fri Apr 29, 2011 3:19 pm   Post subject: deductible and coinsurance  

I have 600 deductible, 80/20 coinsurance. Before surgery, I paid 350 to Doctor and 600 to hospital. After the surgery I paid 100 for tomography. I have 444 dollar pathology bill from hospital and my insurance says I had to pay all money because deductible...Didn't I paid deductible yet....Help please...


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melinda1
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PostPosted: Fri Apr 29, 2011 7:44 pm   Post subject:   

Melinda . . .



Your insurance company may not be aware of the payments you have made to the hospital or doctors. Have you supplied them with the information they need to see that you have already paid the deductible? Additionally, are you certain that the expenses you paid for are all covered expenses?



Although I don't know the sequence of events or timing of payments, or even what's actually covered, based on what you state, it does appear that you may have satisfied the deductible. Present all the bills you have that are marked "PAID" to your insurance company and see what they say.



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PostPosted: Wed Aug 31, 2011 5:59 pm   Post subject: primary ins and seconddary  

I have an account total of 196.00 the primary ins paid 158.27 with adj of 9.80 leaving 27.93 in coinsurance so secondary ins acknowledges primary ins but only puts in a adjustment of 3.92 no payment but under deductibe on secondary it has 192.08. Do we have to acknowledge the secondary adjustment because secondary ins ded is greater than the primary ins coinsurane of 27.93


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danelle
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PostPosted: Wed Aug 31, 2011 6:49 pm   Post subject:   

No clue as to what you are talking about.



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MaxHerr
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PostPosted: Sat Sep 24, 2011 4:48 pm   Post subject:   

A patient is a member of a health plan with a 15% discount from the provider's usual fees and a $10.00 copay. The days' charges are $480.00 What are the amounts the plan and the patient each pay


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Judybooty
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PostPosted: Sat Sep 24, 2011 8:42 pm   Post subject:   

Is this a test? If so, there is not enough information to answer.



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PostPosted: Mon Sep 26, 2011 8:21 pm   Post subject: deductible  

hw can deductible be used as a risk management tools.


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felix theruggedgentleman
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PostPosted: Tue Sep 27, 2011 5:47 am   Post subject:   

It may be one of the most important things you do.



You may consult your insurance agent or even a risk management consultant in determining optimal deductible levels.



The key of risk management is not to insure loses that you can predict and can afford to pay.



Your goal should be to strike a balance between premium savings as well as claims costs.

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PostPosted: Tue Sep 27, 2011 5:52 pm   Post subject:   

You would determine the highest amount of a claim you would be willing to pay with your own funds. Set the deductible at that amount, and your premium will be the lowest possible for that protection. You pay all claims up to that amount, the insurance company pays whatever exceeds that amount in one claim.



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PostPosted: Mon Nov 07, 2011 5:00 am   Post subject:   

It's a form a co-payment and responsible in an effort to have the patient 'see' some of the medical costs and not to overuse their insurance. If they charged them no form of co-payment, then their usage would go up, but if there's a co-pay and deductible, they will be at least a little more hesitant.



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PostPosted: Thu Feb 02, 2012 7:47 pm   Post subject: coinsurance  

what does 100%/60% for coinsurance mean? And also if a company says 100% Coinsurance is that I pay 100% or the Insurance company pays 100%?


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PostPosted: Fri Mar 30, 2012 10:21 am   Post subject: lBgRlKaIPVNDuMkcj  

It is mostly a poasenrl decision. I prefer a large company with a local office staffed by a professional agent who I can speak with face to face in case I have a claim or a question. I dislike playing phone tag with a mindless voice on the telephone or a computer robot. Often those e insurance quotes are low balled to get your business and then later the rates will be raised. You don't necessarily have to visit each agent. use the phone, get quotes, then choose the best one for you (not necessarily the cheapest quote)


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PostPosted: Tue May 01, 2012 8:00 pm   Post subject: First office visit on my own insurance  

Hello,



This may sound very silly, but I am a new student in the United States, and am on my own health insurance plan for the first time, so I am not clear on some concepts.



I have an office visit appointment tomorrow (the cost is $100). My insurance deductible is $350 and after that, my insurance covers 80% (with 20% co-pay). I tried speaking to an insurance representative, and am not quite clear on what all this means.



Does this mean that my $100 office visit will be subtracted from my deductible? Will I have to pay the insurance company the $350 before my plan can be activated?



I guess what I am trying to ask is:



What will my out of pocket expense be for my $100 office visit?



Thanks in advance for your help.


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PostPosted: Wed May 02, 2012 12:16 pm   Post subject: insurance  

I was wondering whether its coinsurance after deductible or is it the whole insurance claim..Say I have a deductible of 500$ and a 70/30 coinsurance policy .When does the coinsurance come into play?After I pay the 500$ deductible or for the whole sum of the insurance claim?

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