Understanding How Co Payments Work In Health Insurance Plans
Wednesday, October 20th, 2010 by adminIf you take out a copy of your health insurance plan, you will see an eligibility and benefits guide. This guide will show what your current co payments are. If you cannot find it, you can call your insurance provider and ask for another copy. There are several different types of co payments to examine.
The first type of co payment is called an "office co-pay." This co payment covers office visits, but it may be different depending on which types of offices that the plan allows you to visit. In-network co payments are always lower than out-of-network co payments. When doctor are in-network, it means that they work with the insurance company and discount their services for those insurance patients as a result. Before you purchase any insurance plan, you should make sure that your current doctor is in your network. If your plan does not allow you to go to chiropractors or massage therapists, it will not cover these services, so make sure before you go to these providers expecting to just pay the co payment.
Another co payment that you will see is your "hospitalization co-pay." This is the co payment that si required when you go to the hospital. People usually understand this co payment much less than they do the routine office co payment. If you do not pay make the hospital co payment, the insurance company will not pay your hospital bill, and the bill may wind up in collections.
A "prescription co-pay" is what you will pay when you go to the pharmacy to get your medicine. It can help considerably because many medications are very expensive.
Usually, the co payment is flat, but your health insurance plan might have a percentage co payment. That means instead of simply paying $25 or $35 every time you go to the doctor, you actually pay a percentage of whatever the actual bill is. Most of these percentage co payments are based on an 80/20 scheme. That means the insurance company pays 80 percent of the bill, and you pay the other 20 percent. This can be difficult because medical costs can be hard to predict.
Many doctors want to be paid for services on the day that they are rendered, so understand your co payment and go to the doctor's office with enough money to cover the portion of the cost that you must pay as part of your plan. No insurance plan pays 100 percent of everything, so you must be prepared to do your part. If you do not, you could end up with very expensive bills that could bring down your credit report and take you completely by surprise.

