Understanding Co-Insurance With a Health Plan
Co-insurance means two parties will be paying for the bill. “Co” means joint, mutual, two, or more. The health insurance company will usually pay the larger amount (example 70%) and you as the member will usually pay the lesser amount (example 30%). This would be considered co-insurance 70/30. This (co-insurance) usually happens AFTER the deductible is met.
A “deductible” is an amount you pay before the insurance company starts paying. Insurance plans will have different “deductibles” $250, $500, $2,000 etc., so read your plan. Think of it like 1st base in a game of baseball. Once you’ve paid all your deductible, you are standing on 1st base. Now you’ll begin to move towards 2nd base – “Co-insurance”. During this time, co-insurance is where you and the insurance company split the medical bills, for example 70/30 or 80/20. Usually, the insurance company will pay the larger amount and you pay the lesser amount.
Your next step is 3rd base or your “Out of Pocket Maximum”. This is the maximum YOU will pay in a year, not the insurance company. Once you’ve met your “out of pocket maximum”, you will no longer have to pay for any future medical services. This also includes the cost of prescription drugs. The insurance company will then pick you up on 3rd base, and carry you to home plate, meaning, the insurance company covers the rest of the bill, no matter how high it is.
Note: This is an annual accrual, meaning it starts over every January 1st and ends December 31st each year.
Getting Help From Nevada Insurance Enrollment
Navigating through the many options of insurance can be confusing and costly. However, speaking with a locally licensed insurance agent will help you to obtain the right coverage you need at a price you should be able to afford. You’ll have peace of mind knowing that you are properly insured when life complications arise. We work hard to find the most competitive quotes for your needs. Contact us today to begin the process of finding the best insurance plan for your family.
Recent Posts
Health Insurance ‘Metal’ Plans Explained
Health insurance companies that sell plans on the Health Insurance Marketplace can offer four types of qualified health insurance plans, including Bronze, Silver, Gold, and Platinum. The plan you choose determines not only the premium you pay but also what portion of your health costs you pay.
Is My Health Insurance Affected If I Miss Open Enrollment?
If you’ve missed the open enrollment period and don’t have a qualifying life event that would allow you to enroll during a special enrollment period, you still have options.
Health Benefits of Good Oral Hygiene
As intimidating as gum disease and its associated conditions sound, the good news is that diligently brushing and flossing daily, along with regular visits to the dentist, is generally enough to keep the bad bacteria under control.
Search This Website
Most Popular Pages
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog
#5) Request a Quote
Top 5 Most Popular
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog Posts
#5) Request a Quote
Recent Posts
Is My Health Insurance Affected If I Miss Open Enrollment?
If you’ve missed the open enrollment period and don’t have a qualifying life event that would allow you to enroll during a special enrollment period, you still have options.
Health Benefits of Good Oral Hygiene
As intimidating as gum disease and its associated conditions sound, the good news is that diligently brushing and flossing daily, along with regular visits to the dentist, is generally enough to keep the bad bacteria under control.
What is a Co-Pay?
A health insurance “Co-pay” is a set dollar amount you pay for a procedure or office visit (look at your plan summary very carefully). A co-pay is helpful because you’ll GENERALLY pay just the co-pay (unless other procedures are billed by your doctor in addition to the co-pay).
Are Breast Reductions Covered by Health Insurance?
Breast reduction surgery is a common procedure that involves removing fat, tissue and skin to reduce the overall breast size. Depending on your reasons for seeking this procedure, it can have a big impact on your comfort, health and quality of life.