Calendar Year Insurance
What is my insurance plan tell me?
I have a deductible of $ 500 per calendar year. My maximum out of pocket limit is $ Calendar year 2500. I have a copayment of $ 15 per visit to my PCP. So I have to pay all my medical care up to this amount reaches $ 500 Insurance comes into play?
Actually, that's not quite true. You pay $ 15 a vist to their primary care provider. That does not imply deductible (and let me assure you that this is not the entire charge.) Regardless of the number of visits, you pay the same price set to see the PCP. However, the money that pays for copayments not count toward your deductible. This is also true for prescription drugs (for most plans.) So, for any other expenses covered (not have fixed co-payments), you must pay the first $ 500 each year. Still, assuming you have a Health Maintenance Organization Plan (which is a safe bet since you have a PCP), you'll find significantly discounted rates compared with people without insurance would pay. After reaching the deductible then you have a co-insurance amount you would pay for any charges. The amount of coinsurance is usually a 80/20 or 90/10 division (which means that you would have to pay between 20 or 10%) to the limit out of pocket for the year. Once again, however, anything that has a co-payment amount (including PCP visits and most likely your prescription drugs) does not count toward the out of pocket limit. So at the end of the year, you may add up your medical bills and find you have paid $ 4,000 (or more) and have not met your $ 2,500 out of pocket limit.
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