health insurance plans?
Can someone please help me understand coinsurance on health insurance plans?
I am trying to get a better deal on health care insurance but don't understand the point of 80% coinsurance. If it is only a few bucks higher with the same deductible, isn't it better to go for the 100% coverage? Does it mean that the insurance co will pay only 80% of the bill once the deductible is met? I don't understand. Please help!
http://answers.yahoo.com/question/index;_ylt=Ah6I21UjodJmZnyKQH9iifCuxQt.;_ylv=3?qid=20090611133555AA71S7H
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Someone's offering you a plan with 100% coverage, for hospitalizations, for only a couple bucks more? Sure, it makes more sence to pay a couple bucks.
Yes, that deductible means, they pay NOTHING until after you've paid the full deductible amount, in medical claims. AFTER the deductible, then you STILL pay 20%, if you've got an 80/20 plan.
or
Yes, that deductible means, they pay NOTHING until after you've paid the full deductible amount, in medical claims. AFTER the deductible, then you STILL pay 20%, if you've got an 80/20 plan.
or
Basically insurance will pay 80% of their contracted amount with the provider and you pay 20%. Here is an example:
$300.00 deductible (this typically applies before any benefits)
Once your deductible is met this is what will happen:
Doctor charges $150.00. Insurance discounts it to $80.00. They pay 80% of that $80.00, so that is $64.00. You will be liable for the balance of $16.00 (20%).
If your policy pays 100%, everything will go to your deductible first and then the insurance will pay 100% of the allowed amount and you pay 0%.
Keep in mind you must follow their network to get the discounted amounts.
$300.00 deductible (this typically applies before any benefits)
Once your deductible is met this is what will happen:
Doctor charges $150.00. Insurance discounts it to $80.00. They pay 80% of that $80.00, so that is $64.00. You will be liable for the balance of $16.00 (20%).
If your policy pays 100%, everything will go to your deductible first and then the insurance will pay 100% of the allowed amount and you pay 0%.
Keep in mind you must follow their network to get the discounted amounts.
Source(s):
work for insurance company
or
The coinsurance on health plans is the % that you pay of your medical bill until you reach your MAXIMUM OUT OF POCKET amount, which for example on an Anthem Bluecross PPO plan typically would be $2500. Lets say your deductible is $500, which means you pay 100% up to $500, and thereafter you pay your % portion up till you reach the max out of pocket. After the max out of pocket has been reached, your insurance will pick up 100% of the bill.
Note that this is during 1 year, so every year it starts over.
or
The coinsurance on health plans is the % that you pay of your medical bill until you reach your MAXIMUM OUT OF POCKET amount, which for example on an Anthem Bluecross PPO plan typically would be $2500. Lets say your deductible is $500, which means you pay 100% up to $500, and thereafter you pay your % portion up till you reach the max out of pocket. After the max out of pocket has been reached, your insurance will pick up 100% of the bill.
Note that this is during 1 year, so every year it starts over.
http://answers.yahoo.com/question/index;_ylt=Ah6I21UjodJmZnyKQH9iifCuxQt.;_ylv=3?qid=20090611133555AA71S7H
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