Can you please explain the difference of medical insurance deductible and co-payment?
Posted on Sep 24, 2009 under Insurance Information |Co-payment is what you pay during visit…but what’s deductible, is it only used during hospitalization?
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Insurance Information
September 24th, 2009 at 8:07 am
Co-payment is what you have to pay as soon as you step into the doctor’s office. It’s cash you have to have in your wallet. A deductible is the amount that the insurance company doesn’t have to pay for. For example. If your co-pay is $20 and your deductible is $100 and you break you leg and go to the hospital, you have to pay $20 up front. If the cast costs $100, you’ve got $80 more to pay to have the whole thing paid off, and the insurance company doesn’t pay anything. If the cast costs $200, you have $80 more to pay, AND the insurance company has to pay the next $100. Or $200. Or $300. In other words, they pay everything above your deductible… unless your insurance says that you eventually have to split the costs… but that’s a question fro your insurance dude.
September 24th, 2009 at 8:07 am
Deductibles depend upon the insurance company. Usually, whatever the amount, you have to spend that much out of your own pocket on medically approved care before the company will pay anything on your bill. For example, if you have a $500 deductible, you have to ante up that much before the company starts paying for hospital bills, lab tests, etc. If you use doctors approved by your insurance company, co-pay is what you have to pay for office visits. This is based on an agreement the doctor has with them and has nothing to do with the deductible. In my experience, it does not apply to the deductible either.