Help with high deductible health insurance

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PostPosted: Tue Jan 20, 2009 6:31 pm   Post subject: Help with high deductible health insurance  

I have a 5,000. deductible on my health insurance that I have to pay first, but when I go into the doctor, do I still give them my insurance card, even though it will not be covered?

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PostPosted: Tue Jan 20, 2009 8:29 pm   Post subject:   

Depends... do you still have some type of network requirement, etc.? There are not many plans out there with this high of a deductible that don't also have some expenses covered at 100% or with a small co-pay (such as preventative care). If you just have a $5000 ded, then I suppose you do not need to present a card. But I'd still call your health insurance company and ask them.

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PostPosted: Tue Jan 20, 2009 11:22 pm   Post subject:   

Quote:
I have a 5,000. deductible on my health insurance that I have to pay first, but when I go into the doctor, do I still give them my insurance card, even though it will not be covered?




Many health insurance programs have a co-pay for doctor's office visits, maybe $20 - $40. Surely you don't have a $5,000 deductible on all medical care and treatment.



If you have a doctor's visit co-pay, it should be shown on the face of your ID card or in the health insurance policy.



Yes, give them your insurance card. Even if you do have a flat $5,000 deductible on everything, this will let your insurance company know that you have satisfied at least a portion of the deductible.


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PostPosted: Wed Jan 21, 2009 7:06 am   Post subject:   

Okay, since its a flat annual deductible and you keep paying small amounts at every doctors' visit you are achieving the high deductible rate. Hence, you may have to pay less as deductible if some major health issue arises at the end of the term of the plan, or am i get it wrong?


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PostPosted: Wed Jan 21, 2009 2:19 pm   Post subject:   

When you go to the doctor with a high deductible plan, you're paying a portion of a pre-negotiated (network) rate, there are typically no copays and no up front costs. The way it works with mine (Golden Rule $5600 deductible), I go to the doctor and pay nothing. The doctor bills by insurance co for the negotiated amount, and I get a bill for the balance in the mail. To answer your question, yes, always give them your insurance card so they know how to bill, but don't expect to pay anything when you go to the doctor, you'll be billed later.



Bandit Baby: Yes, every dollar you spend going to the doctor counts towards your deductible. The point of high deductible plans is really catastrophic coverage. You pay more for each visit but in return pay lower premiums than you would on a regular copay plan. The thing to remember is that as long as you stay in network, $5000 (or whatever your deductible is) plus any coinsurance is the total you're liable for in a year.


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GuyInGeorgia
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PostPosted: Wed Jan 21, 2009 3:18 pm   Post subject:   

I'm not sure this is a newer high deductible plan but it very well could be. I just switched to such a plan so I know very little about it. I was told, and this may be incorrect, that preventative check ups were paid at 100%. This is very well different for each plan. With health care insurance the plans are so different I'd always recommend speaking to the insurance company directly.

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PostPosted: Wed Jan 21, 2009 4:08 pm   Post subject: high deductible  

On my policy, it says preventitive care $200.00 after coverage has been enforce for 12 consecutive months. Phsician's office visit $30.00 copay limited to 2 visits per calender year. I just didn't understand how my $5000.00 deductible is actually paid, meaning what goes towards meeting the $5000.00. That I will be paying out of pocket for any kind of treatment that I may have to have before my $5000.00 is paid.

Thanks


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PostPosted: Wed Jan 21, 2009 4:49 pm   Post subject:   

Anything you pay out of your pocket goes toward the $5000 deductible. If you have a low co-pay, yes... you or your doctor should always send each and every bill into the insurance company. Many doctors will call your carrier and confirm the benefits before your treated. If they can confirm that your carrier will pay all or a portion of the bill, some/many doctors will only charge you your portion and bill your carrier for the difference. But some doctors won't do this. So you'd need to pay the entire bill and send it to your carrier. The problem with this is that your carrier will only consider reasonable charges. If your doctor charges you $100 for an office visit, your carrier may only consider a portion of that if it's above Reasonable and Customary. This is why most will confirm the amount your carrier will consider and bill them for the amount they will pay. I'd not be too concerned about this.

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PostPosted: Wed Jan 21, 2009 10:16 pm   Post subject: high deductible  

That's what I'm going to do, not worry so much about it. I was very lucky to even get any kind of major medical health insurance to begin with. It took forever to get approved by a health insurance company. My husband has high blood pressure, and either he was declined, or the rate was so high that it was impossible to pay the monthly payments. So, now that I have this one with a high $5000.00 deductible, maybe if I keep checking other companies, I will run across a health insurance policy with a lower deductible that I can afford. For now I will deal with what I have.

Thanks for all of your help.

Judy


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Judy B
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PostPosted: Thu Jan 22, 2009 9:02 am   Post subject:   

Quote:
So, now that I have this one with a high $5000.00 deductible, maybe if I keep checking other companies, I will run across a health insurance policy with a lower deductible that I can afford. For now I will deal with what I have.




I wish you all all the luck!!



The high deductible plans also have a limit fixed for the yearly out-of-pocket expense for the insured, for the single individual it could be around $6,000 a year.



Depending upon the HDHP you may receive both on the network and out-of-the-network coverage. However, some policy may limit its benefits only to the inside the network physicians. therefore, make sure that you have read all the prints of the plan.

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charles braveheart
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PostPosted: Thu Jan 22, 2009 2:18 pm   Post subject:   

You should definitely give your insurance card to your doctor. There are two reasons:



    You may pay a lower price.

    Your insurance company will have a record of the visit and will credit the costs towards your deductible. (This is only true if the doctor is in network.)


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PostPosted: Thu Jan 22, 2009 2:19 pm   Post subject:   

Yes!

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PostPosted: Thu Jan 22, 2009 4:40 pm   Post subject: high deductible  

Thank You for the information, Yes, I must stay with the doctors that are in network, Celtic will charge me an additional $1,500 deductible, coverage is only 60% instead of 80%. So, I will always double check this, before doing anything. It costs enough as it is. And now I know to always give them my insurance card. I just wasn't sure how it all works. I have probably read this policy a dozen times, and get more confused each time. Thats why I thought I should get advice and information from other people that certainly know a lot more about health insurance than myself.

Thank You,

Judy


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Judy B.
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PostPosted: Wed Jan 28, 2009 5:37 am   Post subject:   

Also have the pharmacy file your prescriptions on your card, a lot of my clients forget to do this but it does count on a lot of these QHDP plans. Also will get you the pre negotiated drug price just like at the doctors office.



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PostPosted: Sat Jan 31, 2009 3:41 am   Post subject:   

Always carry your card just in case the doctors office needs the info on the card.

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