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.

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What Is Co-Insurance?

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.

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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.

Does Health Insurance Cover Drug Rehab?

Does Health Insurance Cover Drug Rehab?

Many who struggle with substance abuse, also struggle with mental health disorders like depression, anxiety, and bipolar disorder. Often, treatment will include medication, therapy, and rehab for both provided it’s medically necessary.

Catastrophic Health Insurance Explained

Catastrophic Health Insurance Explained

Like major medical health insurance plans, catastrophic health insurance covers the 10 essential health benefits outlined in the Affordable Care Act. However, if you have this type of plan, your out-of-pocket costs for services are considerably higher than with regular health insurance.

 

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#1) Health Insurance Subsidy Chart

#2) Health Insurance

#3) Health Insurance WITH a Subsidy

#4) Insurance Blog

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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

What To Do If Your Doctor Leaves Your Health Plan

If you have been fortunate enough to find a primary or specialty care doctor you love, it can be disappointing to say the least, when your doctor will no longer accept your health insurance plan.

Critical Illness Health Insurance: Should I Have It?

Critical illness insurance, which may also be called critical care insurance or critical illness coverage, pays out a lump-sum, tax-free cash benefit, that can help you take care of any expenses that are associated with a qualifying illness.

What Is An Exclusion In Health Insurance?

In health insurance, an exclusion is a medical procedure or treatment that the health insurance company does not cover. This may include specific medications, surgeries or therapies that are specifically omitted from your policy.