Health insurance: deductibles

by yogesh0505 » Tue Sep 23, 2008 03:17 am

Do insurance companies fight to keep the bills down before deducitble is met

Total Comments: 7

Posted: Tue Sep 23, 2008 09:00 am Post Subject:

Hi yogesh,

You may inquire with your insurance agent regarding this issue. However, if you have opted for a HMO or PPO plan, where the doctor's have already agreed to provide the policy holder's with subsidized medical facilities, the question of negotiating the bill amount doesn't arise.

Thanks,
Rupert

Posted: Tue Sep 23, 2008 09:25 am Post Subject:

Hey, I guess the deductibles are required to be paid no matter whether or not the bill amount was negotiated between the doctor and the insurer.

The deductible is the fixed amount that the policy holder is required to pay each time he decides to turn the claim to his insurer. He is also required to share a certain portion of the total medical expense over and above the amount paid as deductible in the form of co-pay or co-insurance.

~jeremy

Posted: Tue Sep 23, 2008 10:06 am Post Subject:

The concept of co-insurance and co-payment has evolved to prevent both the doctors and the policy holders from inflating or claiming against wrong medical bills. Both copay and co-insurance require the policy holder to share the medical expenses with the insurer.

Posted: Sun Sep 28, 2008 05:57 pm Post Subject:

Actually, they don't fight. They negotiate. That's what :negotiated Network discounts" are.

Posted: Thu Feb 19, 2009 06:59 pm Post Subject: meeting 2 deductibles in one year

We had a policy change in our benefits, but stayed with the same insurance company....I had already met my deduct. for the year and my out of pocket amount....then they changed plans on 12/01/08 and are charging me for another higher deduct. and out of pocket! That does not seem fair or legal.... help!

Posted: Thu Feb 19, 2009 07:48 pm Post Subject:

Was the policy at the end of its year renewal. Some renew sooner than that. I am not sure if it is legal but I have always thought a policy is good for one year and rates could not be changed before hand. An expert here will hopefully come by and let us both know how most policies work.

Posted: Fri Feb 20, 2009 08:44 am Post Subject:

Firey, I think that's indeed a very good catch, no policy term would change at the middle of the term. OP, why do you think the health insurer has changed the terms? May be more information would help the community to post better replies.

Thanks,
Rupert

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