Ok, I just got healthcare insurance. My deductible is 1200.00. What exactly does that mean? I have a "new patient" visit scheduled with a physician. Does this mean that I have to pay out of pocket for all doctor's visits up to $1200.00? How does my insurance company even know how much I have accumulated? What happens if I rarely see a physician? These are reasons I have declined insurance for many years, because I was worried that my premiums ($149.00) will just be spent on the "chance" I might get sick, and then when I do, I will still have to pay $1200.00 out of pocket before the insurance ever kicks in. I'm pretty healthy and it would take many pcp visits to accumulate $1200.00. THANKS FOR YOUR ANSWERS.
2006-11-02 09:51:00 · 0 answers · asked by Medtran01 1 in Business & Finance ➔ Insurance
Routine Physicals, Gynecological Exam, Pap Test,
Mammogram and Pediatric Immunizations.
Deductible does not apply. - 90%
2006-11-02 10:19:41 · update #1
Yes, you pay for EVERYTHING up to the first $1200 before the insurance kicks in.
Your insurance company ONLY knows if you submit those $1200 of bills to them. That means, even though you know it's not covered, you need to send them in! Because the insurance company ONLY counts the $1200 from the bills sent.
With that deductible, what you're looking at is something catastrophic - heaven forbid, cancer, or diabetes, or a heart attack, or menengitis, or pneumonia where you have to be hospitalized, or a really broken bone in your hand or foot that requires surgery.
Don't drop the health insurance! The leading cause of filing bankruptcies is having uninsured health issues!!
2006-11-02 11:34:00 · answer #1 · answered by Anonymous 7 · 0⤊ 0⤋
Health Insurance Deductible Explained
2016-09-30 23:46:55 · answer #2 · answered by ? 4 · 0⤊ 0⤋
From what I understand, the deductible is the amount you have to pay before the insurance will cover any of the expense. So, you would have to pay for health services until you've paid 1200 bucks. I believe that the doctor's office will file a claim with the insurance company no matter what so that's how they would know how much you've accumulated. However, there are some plans where things like office visits or preventative care are not applicable to the deductible so the insurance covers them without you having met the deductible. So, check your plan to make sure what services apply to the deductible. Hope this helps and I may be wrong so knowledgeable folks, please confirm.
2006-11-02 10:07:13 · answer #3 · answered by Anonymous · 2⤊ 0⤋
1
2016-05-28 16:35:52 · answer #4 · answered by ? 3 · 0⤊ 0⤋
Do you have a co-pay for office visits? If you do, then you will only pay the co-pay each time you go for a visit. If not, then you do have to meet the $1200 deductible before the insurance kicks in. If you rarely go to the doctor and are healthy, I would suggest going with a higher deductible to lower your premium. Or, go with a high deductible ($5000 maybe) with a co-pay plan. You need to look over your policy or contact your agent and maybe make some changes. And normally deductibles start over each calendar year. And you may also have a co-insurance to meet. You might check on that.
2006-11-02 09:57:29 · answer #5 · answered by wooohoo12 2 · 1⤊ 1⤋
OK, if you do not have an office co-pay benefit, all charges will go toward your $1200.00 deductible. Per your additional info, your "wellness" benefits have no deductible that applies, and the company will pay 90% of the cost and you pay 10%. Evey time you go to the doctor, they file the claim for you, and the company keeps track of how much you have spent, and if you have met your deductible. I suggest that you find out if prescription drugs go toward your deductible, too. If so, you probably need to keep your receipts and send them in. I also highly suggest you get a different insurance agent. The person that sold you this policy should have explained exactly what you bought and how it works. I am wondering if you have an HSA compatible plan and can also take advantage of tax savings for the HSA account and expenses paid out of that.
2006-11-04 05:54:47 · answer #6 · answered by nurse ratchet 6 · 1⤊ 0⤋
It depends on your insurance. A lot of plans just have a co-pay for office calls (mine is 20 bucks) and the deductible usually refers to everything else. You should have received info on this, as to whether your office calls and prescriptions are covered. If you didn't, ask for the info. There are so many different plans so it's hard to give you a better answer than this.
2006-11-02 09:57:58 · answer #7 · answered by Pooh-Z 2 · 1⤊ 0⤋
You will pay your copay of $30- then after your insurance processes the claim, you will get a bill for the allowable amounts of the visit which was charged. You will be paying about 75-80% of the whole visit on average. Once you have met your yearly deductible then you will pay only your copay of $30.
2016-03-16 01:03:11 · answer #8 · answered by Anonymous · 0⤊ 0⤋