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Om... | I need help understanding Health Insurance Deductibles? |
Ok, so I'm going to get health insurance and I'm Having a challenge trying to understand the deductible situation. The Health Insurance I'm looking into is Blue Shield of California and they have many plans, and it seems that the prices get a bit higher when the deductible gets lower. What does the annual deductible mean? Is that the amount that I have to pay off first before my insurance can cover me? |
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Zarnev
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It will depend on the plan. Generally, if the plans have a doctor co-pay listed as a $ amount you do not have to pay the deductible first. If they have a percentage as the co-pay it is usually after you pay the deductible. If it is an HSA plan you pay the deductible first.
They do have several choices ranging from a basic budget plan with limited coverage up to a comprehensive plan. The comprehensive plans have a higher premium than the basic plans because they have better coverage. The lower the deductible with any plan will have a higher premium.
You also have to consider the co-insurance and maximum out of pocket cap. The budget plans will have a higher maximum and you'll also need to pay a higher percentage.
Visit a local agent that works with Blue Shield as well as the other major plans in your area for help picking the best plan for you. The premium you pay using an agent is the same as you'd pay buying over the internet plus they can answer all your questions. |
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Lisa
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Yes, the deductible is what you pay before the insurance kicks in. |
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debijs
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~~The deductible is the annual amount you have to pay prior to your insurance starting to cover. Read the plans though, some have deductibles, but only apply to lab work, tests, and other procedures. They will only charge you a copay for a doctors visit.
So say it has a deductible of $2,500.00 and you just go to your doctor for a simple cold or flu. Most have an office copay of say $40. That's all you'll pay. If the doctor sends you for x-rays, then your deductible would apply. They will tell the insurance you are only responsible for x amount of money (because the have a contracted rate with the provider). You will pay the difference of the contracted amount and it counts towards your deductible. It would not be the non contracted rate an x-ray would cost to someone with no insurance.
If their are no copays listed, then it's more of a major medical plan. These types are the cheapest of the insurance premiums, and the monthly premium are much cheaper the higher the deductible.~~ |
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stephenweinstein
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Yes, the deductible is the amount you pay before the insurance pays anything. For example, if you have a $1000 deductible, a 20% co-pay, and $2000 in bills, you pay the first $1000 and you pay 20% of the second $1000, for a total of $1200, and the insurance pays 80% of the second $1000, which is $800. If there was a third $1000 in bills (making the total bills $3000), then you would pay another $200 (for a total of $1400) and the insurance would pay another $800 (for a total of $1600). But if there was only $1000 (or less) in bills, then the insurance would pay nothing (because the total of the bills was not more than the deductible) and you would pay everything.
All amounts are per year; the running totals reset every January 1. For example, if you had $1500 in bills for each of two consecutive years, for a total of $3000, you would have to pay the first $1000 of EACH year's bills. You have to pay an amount equal to the deductible EACH year before the insurance pays anything for that year. |
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Penni Q
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Health insurance can be very tricky. Since I live in New Mexico I'm not sure about California regulations, so I recommend you visit a local insurance agent. http://www.goodinternetdeals.com/Health-Insurance.html They should be able to help you. |
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src50
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Annual deductible is what you have to pay each year before the insurance "kicks in" and starts paying. So naturally, the lower the deductible, the higher the premium will be. |
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