What You’ll Pay At The Doctor’s Office Or Before Surgery
A health insurance co-pay (copayment) 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). For example, let’s say you see your family doctor for a sore throat. If your plan has a co-pay of $35 dollars, you’d pay the $35.
Sometimes you can be billed more than just a co-pay. For example, let’s say you went to a specialist (specialist co-pays are generally more than a primary care doctor) to have a spot on your skin looked at.
The office co-pay may be $75 meaning you would pay that much for the office visit. But if the doctor wanted to remove the spot, he could charge you/your insurance company for a “procedure” that is charged in addition to the co-pay. That would be two charges in one visit. So, the procedure could be billed to your insurance company, and you’d pay whatever your insurance company had negotiated with the doctor for that procedure, and that out-of-pocket cost would apply towards your deductible, and the co-pay would apply towards your “out-of-pocket maximum” (the absolute most you’d pay in any calendar year).
In most cases for surgery, most plans will not have a co-pay, but will have a deductible. So, there won’t generally be a co-pay, but before your procedure, you may be asked by the doctor’s office or surgical center or hospital to pay a certain dollar amount. This amount will come off your deductible amount. So, co-pays and deductibles are different, but anything you do pay, whether it’s a co-pay or deductible all applies in one way or the other towards your “out-of-pocket maximum”.
Getting Started With Nevada Insurance Enrollment
While this is a generalization on how most plans work, it’s important to know how your plan works specifically. Navigating through the many options of insurance can be confusing but speaking with a locally licensed insurance agent will help you to obtain the right coverage you need. You’ll have the peace of mind knowing that you are adequately insured when life complications arise. We work hard to find the most competitive quotes, and best coverage 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
Health Insurance with a Preexisting Condition
You may assume that since you have a preexisting condition, you’ll pay a higher premium than someone who is in perfect health. However, an insurer cannot reject you, refuse to pay for health benefits pertaining to your illness or injury, or charge you a higher premium because of your condition.
Is Physical Therapy Covered Under Health Insurance?
Whether you have recently been injured or you are experiencing chronic pain or limited mobility, going to a physical therapist can greatly improve your quality of life. For many people, concerns about how much regular sessions cost is a big roadblock to getting much needed care. Fortunately, if you have an ACA-compliant health insurance plan, rehabilitative services like physical therapy are listed among the essential health benefits.
What Is a Health Insurance Network?
Whether you’ve had the same health insurance company for years or switched to a new health insurance company, the variance in cost is directly related to whether a healthcare provider is within your health insurance company’s network (if you have a PPO), if you have a deductible to satisfy first, or if you have a co-pay.
What is a Special Enrollment Period?
The special enrollment period is always within 60 days of a life event. A “Life Event” is an event such as the birth of a baby, losing group coverage through an employer, losing coverage due to a move to Nevada, marriage, any many other scenarios.