help me understand my health insurance!

posted 3 years ago in Wellness
Post # 3
Member
5697 posts
Bee Keeper
  • Wedding: August 2012

You have a Copay for every visit to one of those provider’s and no they do not count towards your deductible.

Pre deductible, for a 200.00 office visit youwould likely pay this:

25.00 copay

200 office visit minus any provider contracted discount’s (most provider’s accept a discount on services which they ahve agreed upon with the network).

This would continue until you have pay for enough “200.00 office visits” to have met 1500.

Once you have met your deductible:

25.00 copay

150.00 paid for by insurance

50.00 paid for by you

To answer this:

et’s say I go see a doctor who would charge $400 for a visit if you have no insurance

How much do I have to pay?

um, 400 if you have no insurance so I don’t understand this question.

I do this for a living so feel free to PM me any other details, or ask any questions!

 

 

 

Post # 5
Member
5697 posts
Bee Keeper
  • Wedding: August 2012

It depends on how much of a discount your doctor has with your plan. Of course that is assuming there is one, which like I said I have to assume you are on a PPO plan because of the high ded. But you’d probably be looking at about a 10% discount going through insurance, considering you have to pay a copay anyway then yes it’s possible it’s cheaper. 

If you weren’t nearing the plan year then you’d obviously want to have it run through insurance so that it went towards your ded.

I have a 1400.00 deductible, and I always run through insurance, BUT, I don’t have a copay.

Post # 6
Member
5697 posts
Bee Keeper
  • Wedding: August 2012

@bebero:  OH I think I understand what you meant with the 400 now. You were asking if they charge 400 for no insurance, how much do you have to pay WITH insurance?

I read that as “if i go and they charge 400 and I don’t have insurance then what do I pay”. I was like duh! 400.00! LOL

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