Health Insurance FAQ
Readily available information about the price of healthcare services that, together with other information from their physician and insurance plan enables patients to identify, compare, and make informed decisions.
Your annual insurance deductible is the dollar amount specified by your health plan to be paid by you each year before insurance payments will be paid to any healthcare provider for non-preventive services. It is possible that you or your employer chose a higher deductible plan in order to pay a lower monthly premium for insurance coverage. When insurance claims are submitted for payment the health plan processes it to see if the services are covered and how much should be paid. Any deductible amount that has not been paid by you will be subtracted from the amount to be paid for covered services. The healthcare provider will bill you for the amount your insurance plan states is “due from patient”.
Co-insurance is the portion you will pay for covered medical services after your annual deductible is satisfied. Co-insurance is calculated when your health plan processes the claim for services you received. It is typically a percentage of the amount your health plan allows for each procedure or service.
Co-pay is the set amount of money your health plan designates for you to pay each time you receive specific types of healthcare services. This is most commonly paid at your doctor’s office, urgent care or emergency department. This is your portion of the office examination. Additional co-insurance amounts may also be owed if you have tests or procedures during the same visit.