Typically an insurance policy will have a deductible, a coinsurance or copayment and an out of pocket maximum. Although every insurance plan is different and may not have each of these, it’s important to understand them and how they work. It’s especially useful when it comes time to choosing future health care plans.
A deductible is the amount you owe for health care services before your health insurance plan begins to pay.
- For example, if Dwayne Johnson’s deductible is $2,000, he must pay the first $2000 himself.
- After he pays his deductible, he may have to pay a coinsurance or copayment and the insurance company pays the remainder of the amount owed to the provider.
- In some instances there is no coinsurance or copayment once the deductible is met and the insurance company pays in full.
The deductible may not apply to all health care services that you need. Your plan may not require you to pay toward your deductible for certain services like physical therapy or chiropractic care. In these cases, the insurance company will make partial or complete payments for the services you received.
Family health insurance plans often have both an individual deductible, which applies to each person individually, and a family deductible, which applies to all family members as a whole.
For more information regarding insurance benefits, visit www.borjapt.com/blog/health-insurance-101.