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
Stating Your Income For Health Insurance Subsidy
When you claim you make a certain amount of money in a year (and receive a subsidy), you must try to be as accurate as possible and notify them of any changes that may occur throughout the year. Be honest in stating your income. There are very serious consequences to playing games with your income.
Health Insurance, Vision Insurance or Both?
Vision insurance pays for a portion of expenses such as basic preventative care, including vision tests and eye exams. It also covers eyeglasses, including the lenses and the frames, and/or contacts. Depending on your plan, there may be additional benefits, such as coverage for daily disposable contacts.
Comparing Medicare Advantage To Medicare Supplement
During the Medicare Annual Election Period (AEP), which is from October 15th through December 7th each year, many people may ask the question, “Do I want a Medicare Advantage Plan or a Medicare Supplement Plan (Medigap)?”
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
Health Insurance: What is a Single Payer System?
A single-payer health care system is one in which there is one party that collects all healthcare fees and covers all health care costs. In theory, this could reduce medical costs because there would be significantly fewer entities involved in the system, thus cutting down on administrative costs.
What Is A State Based Health Insurance Exchange?
In most cases, when someone is talking about state-based health insurance, they’re referring to a health insurance plan that is regulated by the Department of Insurance in that state. These plans are sold through state health insurance exchanges.
Health Insurance Options For Laid-Off Workers
If you rely on employer-based health insurance and you lose your job, you may wonder what happens if you need medical care before you are able to get new coverage. Fortunately, there is COBRA, a law passed in 1986 gives many workers and their families the right to retain their health insurance even if they quit or lose their jobs.
What Are Association Health Insurance Plans?
Most people have never heard of association health plans; however, these health insurance plans have been around for decades. Association Health Plans may have fewer benefits but will most likely have lower premiums, making them an attractive option for those who are young, healthy, and on a budget.