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.
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Recent Posts
Exchanging Insurance Information After an Accident
Unfortunately, failing to collect the other driver’s personal information and provide them with your own can delay the claims process. On top of that, in Nevada, leaving the scene of an accident without providing personal information is technically a hit and run, which could result in criminal charges.
Does Lying To Your Auto Insurance Company Get You A Better Rate?
Your auto insurance premium is based on a variety of factors, your personal info may cause you to pay more or less for your coverage than your neighbor pays. The application process for auto insurance can be complicated, and not verifying important information or even deliberately lying can have serious consequences.
Nevada is Leaving Healthcare.gov in 2020
Why the Switch Back To Nevada Health Link? There are several reasons for the transition away from HealthCare.gov. Ultimately, the goal is to provide Nevadans with more affordable health insurance coverage, easier access to plans that they need, cost the member and the State less money, and have our own State autonomy.
Changes to Obamacare in 2019
f you’re one of the many Nevadans who rely on health insurance coverage through the Marketplace, then you may have been impacted by some of the recent changes to Obamacare. While a majority of Obamacare has remained in place, 2019 brought a few changes to the program.