How Copayments Work In Health Insurance Policies To Access Services
Tuesday, January 11th, 2011 by adminThe health insurance policy is something everyone needs. For some, it becomes a never ending blur of words and phrases the most people doesn't understand. Learning a few of the terms, and understanding how they affect benefits, can help end the stress and confusion. The term and benefit used the most, other than buying prescriptions, is health insurance co-payments.
Health insurance co-payments are when two parties pay for parts of the same service. The policy holder will co-pay along with the insurance company. If the doctor bill is $100 and the policy holder has a co-pay of $25, then the insurance company is responsible for the other $75.
When a health insurance policy is taken out the member will receive a benefit booklet. This booklet shows all the items covered under the policy, and what the co-pay, deductibles, and co-insurance is for the member.
It is important not to confuse co-insurance with co-pays. They sound a lot alike, but are not the same. Although the part about two parties sharing the cost is still there, they differ just a little. Co-insurance is what the policy holder pays out-of-pocket excluding co-payments. For example, test at a diagnostic center cost $3,000 and the insurance company pays $2,500. The $500 left is the co-insurance the member has to pay. Once the member reaches a certain dollar amount set in the policy, the insurance will then pay 100%.
Co-pays are usually what is paid for services at a doctor's office and in some cases the policy will call for a co-pay at the emergency room. At a doctor's office the co-pay is all the member has to pay. At the emergency room the payment is usually the co-pay, plus co-insurance.
Health insurance co-payments make it easy to access services that otherwise might be too expensive. Policy holders that know they can see the doctor for just the cost of a co-payment are secure in the knowledge their family will always have access to health care and routine checkups.
When seeking medical treatment keep in mind that any test done at the doctor's office will usually fall under the co-pay and not require anymore payment. But, if the doctor sends the patient to another facility for the test, the deductible and co-insurance will have to be paid. The more medical services that can be received at the doctor's office, the less money spent by the member.
Get a copy of the benefits booklet and know what is covered and what is not. Advance knowledge of these services will increase confidence and save stress for the person receiving treatment. Use co-payments whenever possible and save money.

